Individual
ROBBIE THOMAS MANGALASSERIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1150 STATE HIGHWAY 248 STE 200, BRANSON, MO 65616-4186
(417) 336-4112
(417) 335-4684
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-7241
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207RC0000X
Cardiovascular Disease Physician
Primary
2015030667
MO
Other
Enumeration date
07/12/2009
Last updated
01/10/2019
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