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Individual

RICHARD SHANE MANGUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
550 UNIVERSITY BLVD, INDIANAPOLIS, IN 46202-5149
(317) 274-4370
(317) 278-3268
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
01059183A
IN
208600000X
Surgery Physician
Primary
01059183A
IN

Other

Enumeration date
05/12/2006
Last updated
03/30/2022
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