Maganti, Sombabu N
Maganti, Sombabu N is an individual health care provider with primary practice located at 2115 S Fremont Ave Ste 3000, Springfield MO 65804-2239. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Clinical Neurophysiology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Maganti, Sombabu N can be contacted via phone (417) 820-3911.Contact Information
Primary practice address
2115 S Fremont Ave Ste 3000
Springfield MO 65804-2239
Phone: (417) 820-3911
Fax: (417) 820-3924
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2011022935 | Missouri |
| Allopathic & Osteopathic Physicians / Clinical Neurophysiology | 2084N0600X | 25MA08817500 | New Jersey |
Profile Details
| NPI number | 1407142474 |
|---|---|
| LBN Legal business name | Maganti, Sombabu N |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2011 |
| Last updated | Mar 20th, 2012 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407142474 | NPPES |
| Missouri | Other | P00990413 | RR MCR |
| Missouri | MEDICAID | 188731001 | RR MCR |
| Missouri | MEDICAID | 1407142474 | RR MCR |
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