Provider Demographics
NPI:1013094317
Name:MANNING, LAWRENCE ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALAN
Last Name:MANNING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6830 OREGON AVE NW
Mailing Address - Street 2:701-A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2237
Mailing Address - Country:US
Mailing Address - Phone:301-587-4180
Mailing Address - Fax:301-587-9141
Practice Address - Street 1:8121 GEORGIA AVE
Practice Address - Street 2:701-A
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4933
Practice Address - Country:US
Practice Address - Phone:301-587-4180
Practice Address - Fax:301-587-9141
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD36506207X00000X
DC13221207X00000X
VA0101045269207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024492200Medicaid
121697Medicare ID - Type Unspecified
DC024492200Medicaid