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:
Health care specialties
| Specialty | Code | License # | 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 7 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 | 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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