Individual
MARY C. MANCAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1504 SPRINGHILL AVE, SUITE 1430, MOBILE, AL 36604-3207
(251) 405-5147
(251) 434-3852
Mailing address
PO BOX 40480, MOBILE, AL 36640-0480
(251) 470-5842
(251) 470-5809
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
17261
AL
2080P0208X
Pediatric Infectious Diseases Physician
Primary
17261
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00112081
—
MS
05
—
1115606
—
LA
01
—
51088377
BLUE CROSS
AL
01
—
51505893
BLUE CROSS
AL
01
—
92-10078
UNITED HEALTH CARE
AL
Enumeration date
05/20/2006
Last updated
04/15/2008
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