Individual
ANTON TRAVIS MANASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-7270
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
2019-00652
NC
207P00000X
Emergency Medicine Physician
Primary
2019-00652
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447592522
—
NC
Enumeration date
03/26/2013
Last updated
02/27/2024
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