Provider Demographics
NPI:1962489369
Name:MCMANUS, NOLA S (MD)
Entity Type:Individual
Prefix:DR
First Name:NOLA
Middle Name:S
Last Name:MCMANUS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3200 PROVIDENCE DR
Mailing Address - Street 2:PROVIDENCE CHILDREN'S HOSPITAL
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4615
Mailing Address - Country:US
Mailing Address - Phone:907-903-5904
Mailing Address - Fax:907-212-5824
Practice Address - Street 1:3200 PROVIDENCE DR
Practice Address - Street 2:PROVIDENCE CHILDREN'S HOSPITAL
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4615
Practice Address - Country:US
Practice Address - Phone:907-903-5904
Practice Address - Fax:907-903-5904
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2011-03-01
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Provider Licenses
StateLicense IDTaxonomies
CAA 71720208000000X
AK5497208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics