Individual
DR. FRANK SMITH MANCUSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4868 BRIDGE ROAD, SUFFOLK, VA 23435-2048
(757) 483-7900
(757) 483-7151
Mailing address
2000 MEADE PARKWAY, SUFFOLK, VA 23434-4259
(757) 539-0251
(757) 923-9610
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101018464
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6711987
—
VA
Enumeration date
04/25/2006
Last updated
05/14/2009
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