Provider Demographics
NPI:1982790234
Name:MANNING, JAMES R III (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MANNING
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1380 COWELL FARM RD
Mailing Address - Street 2:ATTN: ALLYSON WOOLARD
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-3431
Mailing Address - Country:US
Mailing Address - Phone:252-946-0900
Mailing Address - Fax:252-946-0900
Practice Address - Street 1:628 E 12TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-3409
Practice Address - Country:US
Practice Address - Phone:252-946-0900
Practice Address - Fax:252-946-0900
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-11-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2005-00653207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5901518Medicaid
NC13992OtherBLUE CROSS BLUE SHIELD NC
NC13992OtherBLUE CROSS BLUE SHIELD NC
NC5901518Medicaid