Mandagere, Kelly Ann

Mandagere, Kelly Ann is an individual health care provider with primary practice located at 892 W South Boulder Rd , Louisville CO 80027-2453. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism is her primary health care specialty. Mandagere, Kelly Ann can be contacted via phone (303) 586-5200.

Contact Information

Primary practice address
892 W South Boulder Rd Louisville CO 80027-2453
Phone: (303) 586-5200
Fax: (303) 586-5201
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X 45001 Colorado
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 45001 Colorado

Profile Details

NPI number 1255492104
LBN Legal business name Mandagere, Kelly Ann
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2006
Last updated Jul 20th, 2010 - about 15 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 1255492104 NPPES
Colorado MEDICAID 01159305
Colorado MEDICAID 81287895

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