Basic Information
| Provider Information | |||||||||
| NPI: | 1639244148 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHRISTOPHER | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MANNING | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9263 MEDICAL PLAZA DR | ||||||||
| Address2: | STE E | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294067109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435721228 | ||||||||
| FaxNumber: | 8435766168 | ||||||||
| Practice Location | |||||||||
| Address1: | 9263 MEDICAL PLAZA DR | ||||||||
| Address2: | STE E | ||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294067109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435721228 | ||||||||
| FaxNumber: | 8435766168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/21/2006 | ||||||||
| LastUpdateDate: | 06/09/2014 | ||||||||
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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 | 207L00000X | 28935 | SC | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207R00000X | LL28935 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | P00789433 | 01 | SC | RAILROAD MEDICARE | OTHER | DF5588 | 01 | SC | RAILROAD MEDICARE GIN/GTAN | OTHER |