Individual
FAWN TIENNE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1838 GREENE TREE RD, SUITE 380, PIKESVILLE, MD 21208-6391
(410) 415-5577
(410) 415-6682
Mailing address
2229 E BALTIMORE ST, BALTIMORE, MD 21231-2002
(410) 558-3951
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
H0059003
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400260100
—
MD
Enumeration date
09/15/2005
Last updated
06/05/2024
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