Individual
MS. MANASA JOSYULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
651 S CLARIZZ BLVD, BLOOMINGTON, IN 47401-5523
(812) 333-2304
(812) 330-2306
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01078954A
IN
208000000X
Pediatrics Physician
4301105228
MI
Other
Enumeration date
06/16/2014
Last updated
07/21/2022
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