Individual
DR. MANJULA KOTTAPALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6140 S BROADWAY, LORAIN, OH 44053
(440) 233-7232
(440) 204-4315
Mailing address
6140 S BROADWAY, LORAIN, OH 44053-3821
(440) 204-4315
(440) 204-4315
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35.081604
OH
2084P0804X
Child & Adolescent Psychiatry Physician
35-081604
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2546098
—
OH
Enumeration date
04/04/2007
Last updated
02/01/2019
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