Mangun, Jennie Craig

Mangun, Jennie Craig is an individual health care provider with primary practice located at 2636 Dr Martin Luther King Jr Blvd , New Bern NC 28562-4238. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mangun, Jennie Craig can be contacted via phone (252) 636-1919.

Contact Information

Primary practice address
2636 Dr Martin Luther King Jr Blvd New Bern NC 28562-4238
Phone: (252) 636-1919
Fax: (252) 636-2656
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 009000700 North Carolina

Profile Details

NPI number 1457327272
LBN Legal business name Mangun, Jennie Craig
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 30th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457327272 NPPES
North Carolina Other 141Y6 BCBSNC
North Carolina MEDICAID 5903648 BCBSNC

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