Individual
DR. ANTHONY CHRISTOPHER MANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
11110 MEDICAL CAMPUS RD, SUTIE 126, HAGERSTOWN, MD 21742-6700
(301) 714-4375
(301) 714-4399
Mailing address
11110 MEDICAL CAMPUS RD, SUITE 126, HAGERSTOWN, MD 21742-6700
(301) 714-4375
(301) 714-4399
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
HO0064011
MD
207Y00000X
Otolaryngology Physician
OS-009417L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2173686
MAMSI
MD
01
—
MA1835072
HIGHMARK BLUE SHIELD NUMB
—
Enumeration date
10/28/2005
Last updated
03/12/2008
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