# DR. ANAND MANTRAVADI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1063591402
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 47737-020 | WI | — |
| 207W00000X | Ophthalmology Physician | D0089313 | MD | Yes |
| 207W00000X | Ophthalmology Physician | MD430918 | PA | — |

## Other

- **Enumeration date:** 11/05/2006
- **Last updated:** 01/05/2021