Provider Demographics
NPI:1437124963
Name:MANNING, CHRISTOPHER K (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:MANNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1131 WEST ST
Mailing Address - Street 2:BLDG 1 STE 1
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489
Mailing Address - Country:US
Mailing Address - Phone:860-621-1461
Mailing Address - Fax:860-628-5611
Practice Address - Street 1:1131 WEST ST
Practice Address - Street 2:BLDG 1 STE 1
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489
Practice Address - Country:US
Practice Address - Phone:860-621-1461
Practice Address - Fax:860-628-5611
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT026727207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT490000165Medicare ID - Type Unspecified
CTE53388Medicare UPIN