Individual
MICHAEL JOSEPH MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2215 EXCHANGE PL SE, CONYERS, GA 30013-6723
(770) 922-3522
(770) 922-3662
Mailing address
2215 EXCHANGE PL SE, CONYERS, GA 30013-6723
(770) 922-3522
(770) 922-3662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
033397
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00431747C
—
GA
01
—
005301
CIGNA HEALTHCARE
GA
01
—
0106242
UNITED HEALTHCARE
GA
01
—
080119233
RAILROAD RETIREMENT MEDIC
GA
01
—
4119030001
MEDICARE DME
GA
01
—
5124
KAISER PERMANENTE
GA
01
—
582361278
FEDERAL TAX ID
GA
Enumeration date
06/27/2005
Last updated
11/29/2017
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