Individual
EVELYN W MANETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 ELM AVE SE, EMERGENCY DEPT, ROANOKE, VA 24013-2222
(540) 985-8000
(540) 981-9550
Mailing address
PO BOX 2080, KILMARNOCK, VA 22482-2080
(804) 435-3508
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101034972
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010043085
—
VA
05
—
010043221
—
VA
Enumeration date
09/06/2006
Last updated
05/20/2008
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