Provider Demographics
NPI:1245236959
Name:MANULI, STEVEN P (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:MANULI
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 1:104 MILL END CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8986
Mailing Address - Country:US
Mailing Address - Phone:252-338-5183
Mailing Address - Fax:252-338-5669
Practice Address - Street 1:104 MILL END CT
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8986
Practice Address - Country:US
Practice Address - Phone:252-338-5183
Practice Address - Fax:252-338-5669
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2020-11-02
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-24
Provider Licenses
StateLicense IDTaxonomies
NC182382207RS0012X
NC9601393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1129JMedicaid
NC2252627CMedicare ID - Type Unspecified
NC1129JMedicaid