Individual
CHAD R MANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1975 GLENN MITCHELL DR, STE 200, VA BEACH, VA 23456-0167
(757) 321-3383
(757) 321-3332
Mailing address
230 CLEARFIELD AVE, STE 124, VA BEACH, VA 23462
(757) 321-3383
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101102721
VA
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
0101102721
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004436V01
MEDICARE PTAN
VA
05
—
010064279
—
VA
Enumeration date
06/03/2006
Last updated
02/12/2018
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