Individual
CHARLES MANNIS
Active
Individual
CHARLES MANNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32416
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0900023
UNITED HEALTHCARE
MO
01
—
122201
HEALTHLINK
MO
01
—
22185
BCBS OF MO (ANTHEM)
MO
01
—
3124702001
CIGNA
MO
01
—
3567
GROUP HEALTH PLAN
MO
01
—
4210117
AETNA
MO
01
—
43092556563080A001
WPS TRICARE
—
01
—
A12809
MERCY HEALTH PLANS
MO
01
—
P00195673
RR MEDICARE
MO
Enumeration date
01/19/2007
Last updated
11/09/2007
Update your record
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