Healthcare Provider Details

I. General information

NPI: 1396449955
Provider Name (Legal Business Name): KARTHIK MOHANARANGAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 ALDEN DR
CHEYENNE WY
82005-2945
US

IV. Provider business mailing address

6900 ALDEN DR
CHEYENNE WY
82005-2945
US

V. Phone/Fax

Practice location:
  • Phone: 307-773-3461
  • Fax:
Mailing address:
  • Phone: 307-773-3461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35.156004
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number35.156004
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: