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Individual

NENITA MAGANTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1107 AIRPORT RD, BLOOMINGTON, IL 61704-2544
(309) 662-7700
Mailing address
1107 AIRPORT RD, BLOOMINGTON, IL 61704-2544
(309) 662-7700

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036169395
IL
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/17/2015
Last updated
09/16/2024
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