MEDICARE: DR. SUSHMA MANDA M.D.,

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	D0092183	MD
2	2084N0400X	Neurology Physician	52179	AL
3	2084N0400X	Neurology Physician	25MA11167200	NJ
4	2084N0400X	Neurology Physician	255214	NY
5	2084N0400X	Neurology Physician	01086268A	IN
6	2084N0400X	Neurology Physician	ME117730	FL
7	2084N0400X	Neurology Physician	76059-20	WI
8	2084N0400X	Neurology Physician	MD489137C	PA
9	2084N0400X	Neurology Physician	0101271837	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558524603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSHMA MANDA M.D.,

Provider Business Mailing Address
First Line	:	PO BOX 55310
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-5310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7131 ARLINGTON RD APT 253
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-2944
Country	:	US
Telephone Number	:	315-313-0146
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2008
Last Update Date	:	03/06/2026

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Directions to “ DR. SUSHMA MANDA M.D.,” Practice Location

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