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Individual
RAY PETER MANGULABNAN
Active
Individual
RAY PETER MANGULABNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301072416
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010683841050
COMM CHOICE CARE SOURCE
—
01
—
0992071
HEALTH PLUS OF MI
—
01
—
0N48190
WISCONSIN PHYS SERVICES
—
01
—
1107304342
BCBS OF MI
—
01
—
4411167
MEDICAL SERVICES ADMIN
—
05
—
4411167
—
MI
01
—
7307374
AETNA US HEALTHCARE
—
01
—
MOLINA
QMXPR0027616
MI
01
—
N48190001
MEDICARE
MI
01
—
P25942F
BLUE CARE NETWORK
—
Enumeration date
10/07/2005
Last updated
12/28/2007
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