Individual
MADHAVI REDDY MANDALA
Active
Individual
MADHAVI REDDY MANDALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036114994
IL
207R00000X
Internal Medicine Physician
Primary
MD60253695
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114994
—
IL
01
—
CA1439
RR GROUP NUMBER
IL
01
—
CE9335
RR GROUP NUMBER
IL
01
—
P00393076
RR MEDICARE
IL
01
—
P00406649
RR MEDICARE NUMBER
IL
Enumeration date
08/16/2006
Last updated
09/27/2012
Update your record
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