Individual
CODY ANTHONY MANZANERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425
(843) 792-2575
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL, MSC333, CHARLESTON, SC 29425
(843) 792-2575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL92154
SC
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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