Provider Demographics
NPI:1316088743
Name:MANN, PAUL CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:MANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1120 15TH ST
Mailing Address - Street 2:AUGUSTA UNIVERSITY MEDICAL ASSOCIATES
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30912-0004
Mailing Address - Country:US
Mailing Address - Phone:706-721-2331
Mailing Address - Fax:
Practice Address - Street 1:1120 15TH ST
Practice Address - Street 2:AUGUSTA UNIVERSITY MEDICAL ASSOCIATES
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30912-0004
Practice Address - Country:US
Practice Address - Phone:706-721-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD601663852080N0001X
GA2080N0001X2080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I374088Medicare PIN