Individual
DR. ERIC P MANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
600 MORRIS ST, SUITE 103, CHARLESTON, WV 25301-1409
(304) 388-7040
(304) 388-7041
Mailing address
600 MORRIS ST 103, CHARLESTON, WV 25301-1409
(304) 388-7040
(304) 388-7041
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
09636
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0127930000
—
WV
01
—
P01106930
RAILROAD MEDICARE
WV
Enumeration date
10/05/2006
Last updated
12/21/2015
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