Kodali, Manga Devi

Kodali, Manga Devi is an individual health care provider with primary practice located at 4055 Gateway Blvd , Newburgh IN 47630-8947. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hematology & Oncology. Allopathic & Osteopathic Physicians / Hematology & Oncology is her primary health care specialty. Kodali, Manga Devi can be contacted via phone (812) 858-3051.

Contact Information

Primary practice address
4055 Gateway Blvd Newburgh IN 47630-8947
Phone: (812) 858-3051
Fax: (812) 858-3060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 17645 Mississippi
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME99614 Florida
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X 01072479A Indiana

Profile Details

NPI number 1881635118
LBN Legal business name Kodali, Manga Devi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jun 5th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881635118 NPPES
Mississippi MEDICAID 00126843
Mississippi MEDICAID 279823900

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