DR. VIJAY MANGANNAN (NPI# 1598737900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598737900 |
| Entity Type | Individual |
| Full Name | DR. VIJAY MANGANNAN |
| Credential | MD. |
| Practice Address |
301 North Pine Steet Suite #2 Spartanburg SC 29302 |
| Mailing Address |
301 N Pine St Suite #2 Spartanburg SC 29302-1600 |
| Practice Telephone | 8648046675 |
| Practice Fax Number | 8648046673 |
| Mailing Telephone | 8648046675 |
| Mailing Fax Number | 8648046673 |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2013-02-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 18793 | SC | Other Service Providers |
| N | 163WG0100X |
Registered Nurse Specialization: Gastroenterology |
18793 | SC | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | GP4072 | 05 | |
| SC | T26022 | 05 | |
| SC | STATE LICENSE | 18793 | 01 |
| NC | 89066C9 | 05 |
| Street Address |
301 NORTH PINE STEET SUITE #2 |
| City | SPARTANBURG |
| State | SC |
| Zip Code | 29302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083226476 | Healthstat Inc Grace Management | Preventive Medicine | 951 South Pin Street, Suite 200, Spartanburg, SC 29302 | 2020-08-18 |
| 1467978304 | Katherine Tomes | Speech-Language Pathologist | 355 Cedar Springs Road, Spartanburg, SC 29302 | 2017-08-22 |
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1376995159 | Natalie Nicole Kellett | Nurse Practitioner | 120 Heywood Avenue Suite 200, Spartanburg, SC 29302 | 2016-07-06 |
| 1902273808 | Tamieka Latrell Alston-gibson | Nurse Practitioner | 101 North Pine Street, Suite 210, Spartanburg, SC 29302 | 2015-08-26 |
| 1700209905 | Robert W Wyatt | Pharmacist | 203 Cedar Springs Rd, Spartanburg, SC 29302 | 2014-01-24 |
| 1952735748 | James Sidney Fulmer Sr. | Obstetrics & Gynecology | 167 Ivy Court, Spartanburg, SC 29302 | 2013-08-28 |
| 1053651828 | Jennifer Geddes Hall | Counselor | 101 N Pine St Ste 210, Spartanburg, SC 29302 | 2013-02-15 |
| 1487875514 | Park Place Spartanburg | Assisted Living Facility | 2720 Country Clud Road, Spartanburg, SC 29302 | 2007-05-02 |
| 1740304401 | Leon Derek Herring | Dentist | 270 Cedar Spring Rd, Spartanburg, SC 29302 | 2007-03-19 |
| Find all providers in zip 29302 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396291167 | Brent Timothy Smith | Specialist | 151 Ribault Street Suite 200, Spartanburg, SC 29302 | 2016-08-31 |
| 1891942801 | Scale Down | Specialist | 1455 E Main St Ste 107, Spartanburg, SC 29307-2243 | 2008-08-20 |
| 1124283437 | Allergic Disease and Asthma Center | Specialist | 3020 Reidville Rd, Spartanburg, SC 29301-5641 | 2008-07-25 |
| 1558541094 | Arthritis Care & Therapy Center | Specialist | 391 Serpentine Dr Ste 240, Spartanburg, SC 29303-3079 | 2007-11-13 |
| 1629258827 | Saad Upstate Neurology, P.a. | Specialist | 100 Willow Ln, Suite A, Spartanburg, SC 29307-1365 | 2007-11-06 |
| 1730388109 | Ashley Fowler | Specialist | 250 North Grove Medical Park, Spartanburg, SC 29303-3098 | 2007-07-16 |
| 1376508499 | Bang N Giep | Specialist | 853 N Church St Ste 600, Spartanburg, SC 29303-3070 | 2006-04-20 |
| 1164487377 | Magdy A. Habib | Specialist | 1702 Skylyn Dr, Spartanburg, SC 29307-1040 | 2006-04-19 |
| 1104886001 | William W Kerfoot | Specialist | 391 Serpentine Dr., Suite 500, Spartanburg, SC 29303-3083 | 2006-03-24 |
| 1093781122 | Spartanburg Neurological Center, Pa | Specialist | 1690 Skylyn Drive, Suite 140, Spartanburg, SC 29307 | 2006-02-28 |
| Find all providers in SPARTANBURG | ||||
| City | SPARTANBURG |
| Zip Code | 29302 |
Please comment or provide details below to improve the information on DR. VIJAY MANGANNAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.