Individual
DR. MANJUNATH C MAHADEVAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 N ELM ST, HIGH POINT, NC 27262-4331
(336) 878-6419
(336) 878-6436
Mailing address
5410 MARYLAND WAY, SUITE 300, BRENTWOOD, TN 37027-5064
(615) 371-5765
(888) 241-1404
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2009-00409
NC
207R00000X
Internal Medicine Physician
35.090795
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
153RH
BLUE CROSS/BLUE SHIELD OF NORTH CAROLINA
NC
05
—
5912568
—
NC
Enumeration date
05/23/2008
Last updated
12/14/2009
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