Manning, Shane Nelson

Manning, Shane Nelson is an individual health care provider with primary practice located at 20 Glenlake Pkwy Kaiser Permanente Glenlake, Atlanta GA 30328-3473. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Manning, Shane Nelson can be contacted via phone (620) 662-6000.

Contact Information

Primary practice address
20 Glenlake Pkwy Kaiser Permanente Glenlake Atlanta GA 30328-3473
Phone: (620) 662-6000
Fax: (620) 669-2394
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 07001087A Indiana
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 36003364M Ohio
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X POD001209 Georgia

Profile Details

NPI number 1467447169
LBN Legal business name Manning, Shane Nelson
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Jan 7th, 2022 - about 2 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 1467447169 NPPES
Ohio MEDICAID 2578974
Ohio MEDICAID 200952390

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