Mandala, Madhavi Reddy

Mandala, Madhavi Reddy is an individual health care provider with primary practice located at 202 N Division St Ste 301 , Auburn WA 98001-4939. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Mandala, Madhavi Reddy can be contacted via phone (253) 833-7256.

Contact Information

Primary practice address
202 N Division St Ste 301 Auburn WA 98001-4939
Phone: (253) 833-7256
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036114994 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD60253695 Washington

Profile Details

NPI number 1134232168
LBN Legal business name Mandala, Madhavi Reddy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2006
Last updated Sep 27th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134232168 NPPES
Illinois Other CA1439 RR GROUP NUMBER
Illinois Other P00406649 RR GROUP NUMBER
Illinois Other CE9335 RR GROUP NUMBER
Illinois Other P00393076 RR GROUP NUMBER
Illinois MEDICAID 036114994 RR GROUP NUMBER

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