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Individual

DR. SHAMLAL MANGRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
700 CHILDRENS DR # D00651, COLUMBUS, OH 43205
(614) 722-5315
(614) 355-1597
Mailing address
700 CHILDRENS DR # D00651, COLUMBUS, OH 43205-2664
(614) 722-5315
(614) 355-1597

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
MD10583
RI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
35.133020
OH
207ZP0213X
Pediatric Pathology Physician
Primary
35.133020
OH
207ZP0213X
Pediatric Pathology Physician
MD10583
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007010438
MEDICARE PTAN NUMBER: RIH PATHOLOGY GROUP# 229006187
RI
01
007010439
MEDICARE PTAN NUMBER: TMH PATHOLOGY GROUP# 229006185
RI
05
0286630
OH
05
7010439
RI
01
H636280
MEDICARE PTAN
OH
Enumeration date
05/20/2006
Last updated
03/03/2026
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