Organization
MANNING PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES RAY MITCHELL MD (OWNER)
(803) 435-9447
Entity
Organization
Contact information
Practice address
517 SUNSET DR, MANNING, SC 29102-2208
(803) 435-9447
(803) 435-9975
Mailing address
517 SUNSET DR, MANNING, SC 29102-2208
(803) 435-9447
(803) 435-9975
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22923
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T71482
—
SC
Enumeration date
09/13/2006
Last updated
11/30/2009
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