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Individual

DR. ADITYA MANDAWAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2118

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
248826
MA
207RI0011X
Interventional Cardiology Physician
Primary
58870
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
58870
TN LICENSE
TN
Enumeration date
05/23/2011
Last updated
05/15/2019
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