Individual
HEERAIMANGALORE S MANJUNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2371
(701) 234-3813
Mailing address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-2371
(701) 234-3813
Taxonomy
Speciality
Code
Description
License number
State
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
9450
ND
207RC0000X
Cardiovascular Disease Physician
9450
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1042786
PREFERREDONE
—
05
—
12427
—
ND
01
—
137120
UCARE #
ND
01
—
2259002
AMERICA'S PPO/ARAZ #
ND
01
—
2501505
MEDICA #
ND
01
—
2501717
MEDICA #
ND
01
—
2502164
MEDICA
—
01
—
25027
NDBS #
ND
01
—
27208
ND BCBS
ND
01
—
37999
LHS #
ND
01
—
600G7MA
MN BCBS
MN
05
—
806926300
—
MN
05
—
806926300
—
ND
01
—
917D5MA
MNBS #
ND
01
—
DA9011042786
PREFERRED ONE #
ND
01
—
HP48027
HEALTHPARTNERS #
ND
01
—
HP48027
HEALTPARTNERS
—
Enumeration date
07/04/2006
Last updated
09/17/2021
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