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1346568177
MAMATHA MANDAVA
SHREVEPORT, LA
NPI
1346568177
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: LA 206428)
Enumeration Date
2010-05-04
Last Update Date
2013-08-05
Business Address
-- MAMATHA MANDAVA MD
1501 KINGS HWY DEPARTMENT OF PEDIATRICS
SHREVEPORT, LA 71103-4228
Phone number: 318-675-6076
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Mailing Address
-- MAMATHA MANDAVA MD
1512 W KIRBY PL
SHREVEPORT, LA 71103-3822
Phone number: 318-675-5000
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