Individual
MADHUBALAN MANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5 GARRETT AVE, LA PLATA, MD 20646-5960
(301) 668-9988
Mailing address
196 THOMAS JOHNSON DR, SUITE 215, FREDERICK, MD 21702-4397
(301) 668-9988
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D78075
MD
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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