Individual
VANI MANYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1711 N 6TH 1/2 ST, TERRE HAUTE, IN 47804-2700
(812) 242-3610
(812) 242-3630
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3610
(812) 242-3630
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01044408A
IN
207RH0003X
Hematology & Oncology Physician
35-07-1650M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200063780A
—
IN
05
—
759111
—
OH
01
—
P01012926
RAILROAD MEDICARE
IN
Enumeration date
05/18/2006
Last updated
04/30/2012
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