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Individual
CHARLES E MANNER
Active
Individual
CHARLES E MANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
F1773
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10014424
AMERICAID STAR
—
05
—
137449802
—
TX
05
—
137449805
—
TX
01
—
2224612
BLUE LINK #
—
01
—
25166
AMERIGROUP
—
01
—
4010662
AETNA PROVIDER #
—
01
—
830005870
RAILROAD MEDICARE
—
01
—
85274N
BLUECHOICE SOLUTION
—
Enumeration date
03/29/2006
Last updated
09/15/2022
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