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:
Health care specialties
Specialty | Code | License # | 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 3 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1467447169 | NPPES |
Ohio | MEDICAID | 2578974 | |
Ohio | MEDICAID | 200952390 |
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