Individual
AQEEL H MANDVIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 W 5TH ST, LONDON, KY 40741-2112
(606) 864-4030
(606) 864-0115
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7840
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
31400
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64314016
—
KY
Enumeration date
03/14/2006
Last updated
05/02/2019
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