Individual
DR. MANJULA TELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2735 N CLARKSON ST, FREMONT, NE 68025-7717
(402) 727-9992
(402) 727-7029
Mailing address
2735 N CLARKSON ST, FREMONT, NE 68025-7717
(402) 727-9992
(402) 727-7029
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18925
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30003
BCBS
NE
05
—
47081644800
—
NE
Enumeration date
12/19/2006
Last updated
07/08/2007
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