Individual
DR. VENKATESWARA RAO MANDAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6632 CORINA CT, COLUMBIA, MD 21044-4036
(410) 531-2587
(410) 531-2587
Mailing address
6632 CORINA CT, COLUMBIA, MD 21044-4036
(410) 531-2587
(410) 531-2587
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
D21136
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04194105
—
DC
Enumeration date
02/13/2007
Last updated
03/25/2011
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