Provider Demographics
NPI:1497985386
Name:MANNING, MELISSA C (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:C
Last Name:MANNING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:C
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10901 E MCDOWELL RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85256
Mailing Address - Country:US
Mailing Address - Phone:480-278-7742
Mailing Address - Fax:480-585-5233
Practice Address - Street 1:10901 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85256
Practice Address - Country:US
Practice Address - Phone:480-278-7742
Practice Address - Fax:480-585-5233
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-25
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315042173208000000X
OH35.099424208000000X
AZ50460208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ0016478Medicaid