# MANGESH KANVINDE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1164493623
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 01059611A | IN | — |
| 208D00000X | General Practice Physician | 35076521 | OH | — |
| 208D00000X | General Practice Physician | 39807 | KY | Yes |
| 208D00000X | General Practice Physician | ME96979 | FL | — |

## Other

- **Enumeration date:** 01/31/2006
- **Last updated:** 05/21/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000221371 | UNISON | OH |
| 01 | — | 000000510664 | ANTHEM ID | OH |
| 01 | — | 0304914 | BCMH | OH |
| 05 | — | 2205536 | — | OH |
| 01 | — | 422454 | WELLCARE | OH |
| 01 | — | 733744 | BUCKEYE | OH |
| 01 | — | 7496427 | AETNA | OH |
| 01 | — | P00381873 | RAILROAD MEDICARE | OH |
| 01 | — | P00600867 | RAILROAD MEDICARE | OH |