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Individual

RONNIE DANIEL MANTILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4760 INDEPENDENCE DR, LUMBERTON, NC 28358-2328
(910) 738-9414
(910) 738-1012
Mailing address
5221 PARAMOUNT PKWY STE 220, MORRISVILLE, NC 27560-5490

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2024-00547
NC
207RP1001X
Pulmonary Disease Physician
M15022
ID

Other

Enumeration date
06/20/2012
Last updated
12/18/2024
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