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General NPI Number Information
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NPI Number | 1235123324
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Entity Type | Individual
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Provider Name | AIDA L MANDAPAT MD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 800-223-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 6000 W CREEK RD SUITE 10
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City | INDEPENDENCE
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State | OH
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Zip | 44131-2182
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Country | US
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Telephone | 800-223-2273
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 35038328M
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35038328
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License Number State | OH
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