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Individual
DR. SURESH MANDAVA
Active
Individual
DR. SURESH MANDAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036932
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010036932CT01
ANTHEM BCBS
—
01
—
036932
CONNECTICARE
—
01
—
2046779
AETNA
—
01
—
2V8862
HEALTHNET
—
01
—
9Y214
EMPIRE
—
Enumeration date
07/11/2005
Last updated
03/27/2018
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