Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 29370 | WI |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD37707 | SC |
NPI | 1396700902 |
---|---|
Provider Name | David C Mann |
First Address | North Charleston, SC 29406-3822 |
Second Address | North Charleston, SC 29406-3822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 29/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31416800 | (05) | WI |
E22346 | (02) |