Provider Demographics
NPI:1386919900
Name:MCMANUS, KENNETH DANIEL (DO)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:DANIEL
Last Name:MCMANUS
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:109 G GAINSBOROUGH SQUARE
Mailing Address - Street 2:BOX 723
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320
Mailing Address - Country:US
Mailing Address - Phone:757-490-9388
Mailing Address - Fax:757-490-9401
Practice Address - Street 1:736 BATTLEFIELD BLVD N
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320
Practice Address - Country:US
Practice Address - Phone:757-312-6200
Practice Address - Fax:757-312-6181
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2024-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0102204630207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine