Provider Demographics
NPI:1841696655
Name:MANOR, JOHN (DO, ATC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:MANOR
Suffix:
Gender:M
Credentials:DO, ATC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:410-933-2704
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:6420 ROCKLEDGE DR STE 2100
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7841
Practice Address - Country:US
Practice Address - Phone:301-896-6700
Practice Address - Fax:301-896-6850
Is Sole Proprietor?:No
Enumeration Date:2014-11-06
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDH0099077208100000X
NC19272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer