Provider Demographics
NPI:1043217086
Name:MANNING, STUART HALL (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:HALL
Last Name:MANNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:177 MONTROSE DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-3929
Mailing Address - Country:US
Mailing Address - Phone:919-599-7036
Mailing Address - Fax:919-226-0390
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:C/O DURHAM VA MEDICAL CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-599-7036
Practice Address - Fax:919-226-0390
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0023213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8953898Medicaid
NC202248BMedicare PIN
C85782Medicare UPIN