Individual
MANELLEMA NANDIMITRA FERNANDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
15 W MILWAUKEE ST, SUITE 206, JANESVILLE, WI 53548-2998
(608) 756-0791
Mailing address
15 W MILWAUKEE ST, SUITE 206, JANESVILLE, WI 53548-2998
(608) 756-0791
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
35983-020
WI
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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