Mandava, Anupa
Mandava, Anupa is an individual health care provider with primary practice located at 1169 Eastern Pkwy Ste 3323 , Louisville KY 40217-1415. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Mandava, Anupa can be contacted via phone (718) 300-1540.Contact Information
Primary practice address
1169 Eastern Pkwy Ste 3323
Louisville KY 40217-1415
Phone: (718) 300-1540
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 23781 | Mississippi |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 52580 | Tennessee |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | E9162 | Arkansas |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 23781 | Mississippi |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 52580 | Tennessee |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | 50737 | Kentucky |
| Allopathic & Osteopathic Physicians / Retina Specialist | 207WX0107X | E9162 | Arkansas |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 50737 | Kentucky |
Profile Details
| NPI number | 1710257316 |
|---|---|
| LBN Legal business name | Mandava, Anupa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 12th, 2012 |
| Last updated | Oct 25th, 2021 - about 3 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 | 1710257316 | NPPES |
| Kentucky | MEDICAID | 7100498500 | |
| Kentucky | MEDICAID | Q013565 | |
| Kentucky | MEDICAID | 300008335 | |
| Kentucky | MEDICAID | 02874370 |
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