Provider Demographics
NPI:1710271408
Name:MANSMANN, ERIN H (DO)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:H
Last Name:MANSMANN
Suffix:
Gender:F
Credentials:DO
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 1298
Mailing Address - Street 2:10 FOREST FALLS DRIVE
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-2298
Mailing Address - Country:US
Mailing Address - Phone:207-846-7676
Mailing Address - Fax:
Practice Address - Street 1:10 FOREST FALLS DR
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6936
Practice Address - Country:US
Practice Address - Phone:207-846-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELT12313208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice