Provider Demographics
NPI:1902898018
Name:MANLY, DAVID T (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:MANLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:100 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-5272
Practice Address - Country:US
Practice Address - Phone:828-684-1115
Practice Address - Fax:828-687-6064
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC317332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
260044022OtherRAILROAD MEDICARE B
NC53876OtherBCBS
NC8953876Medicaid
NC53876OtherBCBS
C85296Medicare UPIN