Individual
MICHELE A MANTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7379
(508) 941-6330
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7379
(508) 941-6330
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
257445
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110097754A
—
MA
Enumeration date
08/30/2006
Last updated
03/13/2025
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