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1639817075
MANISH MANDAVA
SPRINGFIELD, IL
NPI
1639817075
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 125079921)
Enumeration Date
2022-05-25
Last Update Date
2022-05-25
Business Address
MANISH MANDAVA MD
800 E CARPENTER ST BOX 43
SPRINGFIELD, IL 62769-0001
Phone number: 217-545-8000
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Mailing Address
MANISH MANDAVA MD
PO BOX 19636
SPRINGFIELD, IL 62794-9636
Phone number: 217-545-8000
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