Individual
REBECCA LEIGH MANGANELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
210 ASHVILLE AVE, CARY, NC 27518-6676
(919) 350-9625
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2022-01884
NC
207Q00000X
Family Medicine Physician
OS16860
FL
207QB0002X
Obesity Medicine (Family Medicine) Physician
Primary
2022-01884
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780117655
—
NC
Enumeration date
04/07/2017
Last updated
03/17/2023
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