Individual
MANORANJAN BODDAPATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 424-6064
(318) 424-6179
Mailing address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 424-6064
(318) 424-6179
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
15337R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174548
—
LA
Enumeration date
07/17/2006
Last updated
07/08/2007
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