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Individual
ANNA M MANDALAKAS
Active
Individual
ANNA M MANDALAKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
35-072385
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183305
ANTHEM
OH
01
—
000000221080
UNISON
—
01
—
000000526102
ANTHEM
OH
01
—
2012575
BCMH
OH
05
—
2012575
—
OH
01
—
2352239
AETNA
OH
01
—
363801
WELLCARE
OH
Enumeration date
07/18/2006
Last updated
07/20/2011
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