# DR. MANSOOR MADANI

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

## Provider details

- **NPI number:** 1568646628
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DS023126L | PA | Yes |

## Other

- **Enumeration date:** 12/26/2007
- **Last updated:** 03/04/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1610569 | HIGHMARK | PA |
| 01 | — | 172847 | BLUE SHIELD | PA |
| 01 | — | 4517236 | AETNA | PA |
| 01 | — | MA172847 | HIGHMARK | PA |