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Organization
VASUDEVAR RAO MANDAVA MD PC
Active
Organization
VASUDEVAR RAO MANDAVA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNDI L SANCHEZ (BILLING MANAGER)
(586) 773-1823
Entity
Organization
Contact information
Practice address
43171 DALCOMA DR STE 8, STE 8, CLINTON TOWNSHIP, MI 48038-6307
(586) 263-9772
(586) 263-4577
Mailing address
43171 DALCOMA DR STE 8, STE 8, CLINTON TOWNSHIP, MI 48038-6307
(586) 263-9772
(586) 263-4577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
VM031566
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1096276
—
MI
01
—
110E021360
BCBS GROUP
MI
Enumeration date
11/14/2007
Last updated
01/03/2011
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