Individual
PAUL MANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10755 FALLS RD, LUTHERVILLE, MD 21093-4515
(410) 955-5837
Mailing address
PO BOX 64165, BALTIMORE, MD 21264-4165
(410) 955-9469
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D20445
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
714211100
—
MD
Enumeration date
06/21/2006
Last updated
02/12/2013
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