Individual
JOSHUA LEE MANGHELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7120 CLEARVISTA DR STE 3200, INDIANAPOLIS, IN 46256-1782
(317) 621-7780
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
02006817A
IN
2086X0206X
Surgical Oncology Physician
Primary
02006817A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11018189A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300064880
—
IN
Enumeration date
06/02/2015
Last updated
12/04/2023
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