Organization
MANTE PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBENEZER MANTE M.D. (OWNER)
(803) 313-3846
Entity
Organization
Contact information
Practice address
834 W MEETING ST, SUITE C, LANCASTER, SC 29720-6220
(803) 313-3846
(803) 313-3847
Mailing address
834 W MEETING ST, SUITE C, LANCASTER, SC 29720-6220
(803) 313-3846
(803) 313-3847
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4702
—
SC
Enumeration date
06/27/2007
Last updated
02/06/2008
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