Individual
FORAM ASHWIN MANKODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
301 2ND ST NE, NEW PRAGUE, MN 56071-1709
(952) 758-4431
Mailing address
301 2ND ST NE, NEW PRAGUE, MN 56071-1709
(952) 758-4431
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
52828
MN
Other
Enumeration date
06/03/2010
Last updated
09/18/2020
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