Provider Demographics
NPI:1770524209
Name:MANGER, DONALD CHRISTOPHER (DPM)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CHRISTOPHER
Last Name:MANGER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 S OLDEN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-2907
Mailing Address - Country:US
Mailing Address - Phone:609-586-7111
Mailing Address - Fax:609-586-7311
Practice Address - Street 1:1300 S OLDEN AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-2907
Practice Address - Country:US
Practice Address - Phone:609-586-7111
Practice Address - Fax:609-586-7311
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD02061213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6537707Medicaid
5460090001OtherDMERC
NJ6537901Medicaid
NJ676846T7WMedicare ID - Type Unspecified
NJ6537901Medicaid
5460090001OtherDMERC