Individual
GERALD L MANCEBO
Active
Individual
GERALD L MANCEBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14580
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1100098566
RR MEDICARE PIN
TN
05
—
3198177
—
TN
Enumeration date
06/15/2006
Last updated
10/18/2023
Update your record
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