Individual
DEVENDRANATH REDDY MANNURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103-6132
(218) 786-8364
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
(218) 786-8364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
049949
CT
207R00000X
Internal Medicine Physician
12834
ND
207R00000X
Internal Medicine Physician
PT 12834
ND
208M00000X
Hospitalist Physician
Primary
12834
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023273273
—
MN
05
—
18023
—
ND
Enumeration date
07/26/2008
Last updated
07/11/2025
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