Individual
DR. GERALD PETER MCMANAMA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3154 WEST 11TH AVE, EUGENE, OR 97402
(541) 988-6200
(541) 988-6215
Mailing address
3154 WEST 11TH AVE, EUGENE, OR 97402-8381
(541) 988-6200
(541) 988-6215
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
MD160341
OR
2086S0129X
Vascular Surgery Physician
R7H29
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202643524
—
MO
05
—
500654960
—
OR
01
—
770000741
RAILROAD MEDICARE
MO
Enumeration date
07/11/2006
Last updated
04/14/2017
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