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Organization

STEWART CLEAVES MANNING, MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEWART CLEAVES MANNING M.D. (DOCTOR)
(252) 338-2144
Entity
Organization

Contact information

Practice address
1121 N ROAD ST STE A, ELIZABETH CITY, NC 27909-3470
(252) 338-2144
(252) 338-2145
Mailing address
1121 N ROAD ST STE A, ELIZABETH CITY, NC 27909-3470
(252) 338-2144
(252) 338-2145

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
38380
NC
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
38380
NC
261QP2300X
Primary Care Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2335896
MEDICARE PTAN
05
6953907
NC
Enumeration date
05/08/2007
Last updated
07/21/2022
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