Provider Demographics
NPI:1841480266
Name:CP MCMANUS AND RP MCMANUS MD LTD
Entity type:Organization
Organization Name:CP MCMANUS AND RP MCMANUS MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-525-7040
Mailing Address - Street 1:2525 NORTH TENTH STREET
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-1998
Mailing Address - Country:US
Mailing Address - Phone:703-525-7040
Mailing Address - Fax:703-525-0084
Practice Address - Street 1:2525 NORTH TENTH STREET
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-1998
Practice Address - Country:US
Practice Address - Phone:703-525-7040
Practice Address - Fax:703-525-0084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101014849207Q00000X
VA0101046655207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD75399Medicare UPIN
169503Medicare PIN
704442Medicare PIN
VAC62198Medicare UPIN