Individual
AMRENDRA KUMAR MANDAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 N PATTERSON ST, VALDOSTA, GA 31602-1735
(229) 433-1000
Mailing address
36 PRESIDENTIAL CTS, SYRACUSE, NY 13202-2477
(315) 464-1600
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
93364
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2017
Last updated
06/09/2023
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