Individual
DR. PURNA PRASAD MANNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
934 VANDORA SPRINGS RD, GARNER, NC 27529-3544
(919) 779-2851
Mailing address
934 VANDORA SPRINGS RD, GARNER, NC 27529-3544
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
200500220
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
139N3
BLUE CROSS BLUE SHIELD
NC
05
—
5900872
—
NC
01
—
P00237086
RAILROAD MEDICARE
NC
Enumeration date
01/26/2006
Last updated
12/11/2012
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