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Individual

CHAITANYA MANDAPAKALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
651 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-5423
(859) 757-2927
(859) 341-0203
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 757-2927
(859) 341-0203

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301095990
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
50416
KY
207RP1001X
Pulmonary Disease Physician
Primary
50416
KY

Other

Enumeration date
06/18/2010
Last updated
03/11/2021
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