Provider Demographics
NPI:1801863782
Name:MANKIE, DONALD E (RD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:E
Last Name:MANKIE
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4633 BRAMBLETON AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-3410
Mailing Address - Country:US
Mailing Address - Phone:540-400-7733
Mailing Address - Fax:
Practice Address - Street 1:4633 BRAMBLETON AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3410
Practice Address - Country:US
Practice Address - Phone:540-400-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
P62211Medicare UPIN
VA00W771L97Medicare ID - Type UnspecifiedMEDICARE - RICHMOND