Individual
MARY BETH MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
44 BLAINE AVE, BEDFORD, OH 44146-2709
(440) 735-3900
(330) 656-5901
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5021
(330) 656-9304
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35058161M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000162489
ANTHEM
OH
01
—
000000381220
ANTHEM
OH
05
—
0807550
—
OH
Enumeration date
12/16/2005
Last updated
06/11/2008
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