Mandava, Suresh

Mandava, Suresh is an individual health care provider with primary practice located at 2046 W Main St Ste 2 , Stamford CT 06902-4523. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Mandava, Suresh can be contacted via phone (203) 869-3082.

Contact Information

Primary practice address
2046 W Main St Ste 2 Stamford CT 06902-4523
Phone: (203) 869-3082
Fax: (203) 869-6453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036932 Connecticut

Profile Details

NPI number 1477551869
LBN Legal business name Mandava, Suresh
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 11th, 2005
Last updated Mar 27th, 2018 - about 8 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 1477551869 NPPES
Other 010036932CT01 ANTHEM BCBS
Other 2046779 ANTHEM BCBS
Other 036932 ANTHEM BCBS
Other 2V8862 ANTHEM BCBS
Other 9Y214 ANTHEM BCBS

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