Provider Demographics
NPI:1649211715
Name:MANN, WILLIAM OLIVER (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:OLIVER
Last Name:MANN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:308 RALEIGH ROAD PKWY W
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-2945
Mailing Address - Country:US
Mailing Address - Phone:919-987-5113
Mailing Address - Fax:252-822-0194
Practice Address - Street 1:308 RALEIGH ROAD PKWY W
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-2945
Practice Address - Country:US
Practice Address - Phone:252-548-6890
Practice Address - Fax:252-822-0194
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2000015102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG77090Medicare UPIN