Individual
MARK J. MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
119 BELMONT ST, DEPARTMENT OF OB/GYN, WORCESTER, MA 01605-2903
(508) 334-8459
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
218465
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110077315A
—
MA
Enumeration date
01/22/2007
Last updated
11/11/2020
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