Individual
JULIE MANLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-4000
Mailing address
106 N EAST ST, RALEIGH, NC 27601-1112
(208) 869-8018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200600987
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBS PROVIDER NUMBER
NC
05
—
PENDING
—
NC
Enumeration date
07/08/2006
Last updated
08/28/2013
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