Provider Demographics
NPI:1750532552
Name:MANCHESTER, ANNE C (MD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:C
Last Name:MANCHESTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LINCOLN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3290
Mailing Address - Country:US
Mailing Address - Phone:970-542-4390
Mailing Address - Fax:
Practice Address - Street 1:1000 LINCOLN ST STE 200
Practice Address - Street 2:
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3290
Practice Address - Country:US
Practice Address - Phone:970-542-4400
Practice Address - Fax:970-542-4401
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48261174400000X
CODR.0048261208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist