Individual
MOHAN KRISHNA BANGARU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301119098
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
B526609478425
DRIVING LICENSE
MI
Enumeration date
08/16/2014
Last updated
07/21/2022
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