Individual
DR. PETER BRUCE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-1196
(314) 747-3977
Mailing address
660 S EUCLID AVE, C B 8234, SAINT LOUIS, MO 63110-1010
(314) 362-1196
(314) 747-3977
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2012037425
MO
2086S0120X
Pediatric Surgery Physician
Primary
2012037425
MO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
2012037425
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891747697
—
MO
05
—
ENROLLED
—
IL
Enumeration date
05/17/2006
Last updated
01/24/2018
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