Individual
DR. CHERYL A MANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
805 E PIKE ST, JACKSON CENTER, OH 45334-0626
(937) 596-0456
(937) 596-0462
Mailing address
805 E PIKE ST, JACKSON CENTER, OH 45334-0626
(937) 596-0456
(937) 596-0462
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35069861
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000233110
ANTHEM PIN #
OH
01
—
010645905
TAX ID #
OH
01
—
080186052
RAILROAD MEDICARE
OH
05
—
2020306
—
OH
Enumeration date
06/16/2005
Last updated
01/04/2017
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