Individual
DR. SIVA KRISHNA MANNEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
808 N 39TH AVE, YAKIMA, WA 98902
(509) 574-3400
(509) 574-3464
Mailing address
808 N 39TH AVE, YAKIMA, WA 98902-6388
(509) 574-3600
(590) 574-3654
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10037503
TX
207RH0003X
Hematology & Oncology Physician
64330
WI
207RH0003X
Hematology & Oncology Physician
Primary
MD60707157
WA
207RX0202X
Medical Oncology Physician
48381
KY
207RX0202X
Medical Oncology Physician
64330
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2072035
—
WA
Enumeration date
10/05/2010
Last updated
08/07/2019
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