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Individual
DEBORAH JOY MANNING
Active
Individual
DEBORAH JOY MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD112734
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25584030
BCBS PROVIDER NUMBER
MO
01
—
MD112734
STATE LICENSE NUMBER
MO
Enumeration date
06/12/2006
Last updated
10/09/2024
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