Provider Demographics
NPI:1700562444
Name:MANNING, CEALUS RUDEN III
Entity Type:Individual
Prefix:MR
First Name:CEALUS
Middle Name:RUDEN
Last Name:MANNING
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6763 PAGE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63133-1635
Mailing Address - Country:US
Mailing Address - Phone:314-379-9085
Mailing Address - Fax:
Practice Address - Street 1:6763 PAGE AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63133-1635
Practice Address - Country:US
Practice Address - Phone:314-379-9085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist