Individual
HEATHER D MANNUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-2567
(410) 328-0248
Mailing address
PO BOX 62602, BALTIMORE, MD 21264-2602
(410) 328-2567
(410) 328-6896
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
D0057936
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
409075600
—
MD
01
—
647223-01
BC/BS
MD
01
—
S053-0058
BC/BS REGIONAL
MD
Enumeration date
03/23/2006
Last updated
03/07/2011
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