Individual
MANGESH KANVINDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
361 CROSS ROADS BLVD, COLD SPRING, KY 41076
(859) 474-0374
Mailing address
361 CROSS ROADS BLVD, COLD SPRING, KY 41076-2194
(859) 474-0374
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
01059611A
IN
208D00000X
General Practice Physician
35076521
OH
208D00000X
General Practice Physician
Primary
39807
KY
208D00000X
General Practice Physician
ME96979
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221371
UNISON
OH
01
—
000000510664
ANTHEM ID
OH
01
—
0304914
BCMH
OH
05
—
2205536
—
OH
01
—
422454
WELLCARE
OH
01
—
733744
BUCKEYE
OH
01
—
7496427
AETNA
OH
01
—
P00381873
RAILROAD MEDICARE
OH
01
—
P00600867
RAILROAD MEDICARE
OH
Enumeration date
01/31/2006
Last updated
05/21/2018
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