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Individual

DR. VENKATACHALAM MANGESHKUMAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
MD061259L
PA
207R00000X
Internal Medicine Physician
MD0611259L
PA
2084N0400X
Neurology Physician
Primary
MD0611259L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001672400 0003
PA
05
0016724000003
PA
Enumeration date
09/08/2005
Last updated
11/06/2023
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