Individual
DR. EDWARD MANNINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 ROBERT BLVD STE 100, SLIDELL, LA 70458
(985) 280-8688
(985) 280-6642
Mailing address
1120 ROBERT BLVD STE 100, SLIDELL, LA 70458-2068
(985) 280-8688
(985) 280-6642
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
302504
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/17/2011
Last updated
01/22/2020
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