Provider Demographics
NPI:1508158296
Name:MANOS, TONI NMI (MD)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:NMI
Last Name:MANOS
Suffix:
Gender:F
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 49
Mailing Address - Street 2:1742 E.ASHLEY AVE.
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439-0049
Mailing Address - Country:US
Mailing Address - Phone:843-588-6300
Mailing Address - Fax:843-588-6300
Practice Address - Street 1:1742 E. ASHLEY AVE.
Practice Address - Street 2:
Practice Address - City:FOLLY BEACH
Practice Address - State:SC
Practice Address - Zip Code:29439-0049
Practice Address - Country:US
Practice Address - Phone:843-588-6300
Practice Address - Fax:843-588-6300
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12572207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services