Individual
MOUNIKA MANDADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4003 KRESGE WAY STE 500, LOUISVILLE, KY 40207-5603
(502) 897-1166
(502) 897-1461
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4900
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
45366
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45366
LICENSE
KY
05
—
7100142880
—
KY
01
—
K129880
MEDICARE
KY
Enumeration date
08/21/2009
Last updated
12/08/2020
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