Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 5101020397 | MI |
NPI | 1285974964 |
---|---|
Provider Name | Dr. Drue A Manning |
First Address | Clinton Township, MI 48038-3504 |
Second Address | Clinton Township, MI 48038-3504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2013 |
Last Update Date | 17/02/2017 |