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Individual

DR. MATTHEW T MANZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
10 AVIEMORE DRIVE, PINEHURST, NC 28374
(910) 215-5555
(910) 215-0366
Mailing address
10 AVIEMORE DRIVE, PINEHURST, NC 28374
(910) 215-5555
(910) 215-6134

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36221
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2182209D
MEDICARE
NC
01
53849
BCBS INDIVIDUAL
NC
05
8953849
NC
Enumeration date
05/05/2006
Last updated
12/14/2009
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