Provider Demographics
NPI:1053312959
Name:MCMANUS, PAUL EMMET (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:EMMET
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1798
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-1798
Mailing Address - Country:US
Mailing Address - Phone:404-292-2500
Mailing Address - Fax:404-294-9361
Practice Address - Street 1:1457 SCOTT BLVD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:404-292-2500
Practice Address - Fax:404-294-9361
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA030822207WX0009X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00371533CMedicaid
GA18BDBDLMedicare ID - Type UnspecifiedMEDICARE PROV ID
GA00371533CMedicaid