Individual
DR. SHANE NELSON MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
20 GLENLAKE PKWY, KAISER PERMANENTE GLENLAKE, ATLANTA, GA 30328-3473
(620) 662-6000
(620) 669-2394
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 365-0966
(620) 669-2394
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
07001087A
IN
213ES0103X
Foot & Ankle Surgery Podiatrist
36003364M
OH
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001209
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200952390
—
IN
05
—
2578974
—
OH
Enumeration date
09/19/2005
Last updated
01/07/2022
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