Provider Demographics
NPI:1316234685
Name:MANGIERI, CHRISTOPHER WESLEY (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WESLEY
Last Name:MANGIERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:207 SUNBURY DR
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-7252
Mailing Address - Country:US
Mailing Address - Phone:980-322-6776
Mailing Address - Fax:
Practice Address - Street 1:300 E HOSPITAL RD., FORT GORDON, GA 30905
Practice Address - Street 2:EISENHOWER ARMY MEDICAL CENTER, DEPT. GENERAL SURGERY
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:30905
Practice Address - Country:US
Practice Address - Phone:706-305-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC91391208600000X
GA69352208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery