Individual
THOMAS A MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
4301051273
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018148280003
—
PA
Enumeration date
07/12/2006
Last updated
06/13/2016
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