| Doctor Name: | FAWN TIENNE MANNING |
| NPI Number: | 1568457513 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | H0059003 |
| Business Practice Address: | 1838 Greene Tree Rd Suite 380 Pikesville, MD - 212086391 |
| Business Phone Number: | 4104155577 |
| Business Fax Number: | 4104156682 |
| Mailing Address: | 2229 E Baltimore St, BALTIMORE |
| State: | MD |
| Postal Code: | 212312002 |
| Phone Number: | 4105583951 |
| Fax Number: | |
| NPI Enumeration Date: | 09/15/2005 |
| NPI Last Update Date: | 06/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | H0059003 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | 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. |