Provider Demographics
NPI:1932288339
Name:MANEICE, DONNA KAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:KAY
Last Name:MANEICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:PAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4280 WATERMELON RD STE 112
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5250
Mailing Address - Country:US
Mailing Address - Phone:205-750-0030
Mailing Address - Fax:205-750-0855
Practice Address - Street 1:4280 WATERMELON RD STE 112
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5250
Practice Address - Country:US
Practice Address - Phone:205-750-0030
Practice Address - Fax:205-750-0855
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-04
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA60026207RR0500X
AL15326207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL143365OtherAMERICAN BOARD OF INTERNAL MEDICINE
AL51000132OtherBLUE CROSS/ BLUE SHIELD
AL51555420Medicare ID - Type Unspecified