Individual
KAVITHA VANI MANJUNATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
1450 SCALP AVE, SUITE 003B, JOHNSTOWN, PA 15904-3374
(814) 269-9551
(814) 266-6263
Mailing address
1086 FRANKLIN ST, JOHNSTOWN, PA 15905-4305
(814) 410-8300
(814) 410-8331
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD430862
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018582080002
—
PA
Enumeration date
02/12/2007
Last updated
01/09/2013
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