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Individual

DR. MAHENDRA MANGRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0116016860
VA
207RN0300X
Nephrology Physician
Primary
MD21836
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2013-01034
MEDICAL LICENSE
NC
01
43797
MEDICAL LICENSE
AZ
01
49419
MEDICAL LICENSE
CO
01
7742820-1205
MEDICAL LICENSE
UT
01
MD2010-0606
MEDICAL LICENSE
NM
01
MD21836
MEDICAL LICENSE
ME
Enumeration date
01/31/2008
Last updated
12/20/2017
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