Basic Information
| Provider Information | |||||||||
| NPI: | 1295869360 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MANNING | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | C. | ||||||||
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| Credential: | M.D., PH.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 JOHNSTON DR | ||||||||
| Address2: | |||||||||
| City: | BLOOMSBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088049559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9088925229 | ||||||||
| FaxNumber: | 9739662820 | ||||||||
| Practice Location | |||||||||
| Address1: | 545 RAY C HUNT DR | ||||||||
| Address2: | UVA PAIN MANAGEMENT | ||||||||
| City: | CHARLOTTESVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 22903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4349242283 | ||||||||
| FaxNumber: | 4349820019 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 02/12/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | 0101049588 | VA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
ID Information
| ID | Type | State | Issuer | Description | 005716420 | 05 | VA | MEDICAID |