Mandava, Vasudevarao

Mandava, Vasudevarao is an individual health care provider with primary practice located at 18 Market St Suite C, Mount Clemens MI 48043. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mandava, Vasudevarao can be contacted via phone (586) 783-2222.

Contact Information

Primary practice address
18 Market St Suite C Mount Clemens MI 48043
Phone: (586) 783-2222
Fax: (586) 783-6280
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X VM031566 Michigan

Profile Details

NPI number 1073501821
LBN Legal business name Mandava, Vasudevarao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2005
Last updated Sep 24th, 2020 - about 4 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 1073501821 NPPES
Michigan MEDICAID 1096276

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