MICHELE MANGUM M.D. NPI 1417952169

NPI Information

NPI: 1417952169
Provider Name: MICHELE MANGUM, M.D.
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

Address:
701 GROVE RD
GREENVILLE, SC
ZIP 29605
Phone: (864) 455-7000
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Michele Mangum, M.D. is a neurology psychiatry neurology in Greenville, SC. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Michele Mangum, M.D. NPI is 1417952169. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 GROVE RD
GREENVILLE, SC
ZIP 29605-210
Phone: (864) 455-7000

The enumeration date for this NPI number is 6/18/2005 and was last updated on 9/5/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	200100262	NORTH CAROLINA	No
2	2084N0400X	Psychiatry & Neurology	Neurology	11868	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	2289256	MEDICARE PIN	NORTH CAROLINA
2	AA63338768	MEDICARE PIN	SOUTH CAROLINA
3	D01185	MEDICARE UPIN
4	118688	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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