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General NPI Number Information
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NPI Number | 1538328992
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Entity Type | Individual
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Provider Name | GEETA KARNIK MANTRAVADI M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 06/02/2008
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Last Update Date | 07/20/2022
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Provider Practice Location Address
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Address Line | 1633 N CAPITOL AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-1261
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Country | US
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Telephone | 317-962-0963
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Fax |
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 36133163
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 01077366A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01077366A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.133163
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License Number State | IL
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD038106
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License Number State | DC
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