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Individual

DR. MANGALA VENKATESH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2300 MIAMI VALLEY DR STE 550, CENTERVILLE, OH 45459-1298
(937) 438-7500
(937) 438-7555
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35045891
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0496020
OH
01
0520032
UNITED HEALTHCARE
OH
01
3160053075G36
ANTHEM
OH
01
7138684001
CIGNA
OH
01
D45891
CHOICECARE
OH
Enumeration date
01/11/2006
Last updated
10/22/2020
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