Individual
MANUDEEP K MAHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 STATE AVE N, KENT, WA 98030-4544
(253) 372-7866
Mailing address
222 STATE AVE N, KENT, WA 98030-4544
(253) 372-7866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60111548
WA
208D00000X
General Practice Physician
MD60111548
WA
Other
Enumeration date
05/05/2008
Last updated
04/01/2011
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