Individual
MICHELE MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-7000
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
11868
SC
2084N0400X
Neurology Physician
200100262
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
118688
—
SC
Enumeration date
06/18/2005
Last updated
09/05/2013
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