ANDREW MANDERY MD PLASTIC SURGERY LLC; NPI #1629399266

Contact Information

ANDREW MANDERY MD PLASTIC SURGERY LLC

1948 W BOULEVARD
KOKOMO, IN 46902-6078

Phone: 765-236-1290
Fax: 765-236-0420
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Plastic and Reconstructive Surgery	2086S0122X	02	Physician/General Surgery

Indicates primary specialty

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NPI Profile & details for ANDREW MANDERY MD PLASTIC SURGERY LLC

NPI Number 1629399266

LBN Legal business name ANDREW MANDERY MD PLASTIC SURGERY LLC

Authorized official ANDREW MANDERY - (PHYSICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/17/2010

Last updated 07/02/2014 - About 12 years ago

Identifiers

IN	License #	01045232
IN	Medicaid	200101450B

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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ANDREW MANDERY MD PLASTIC SURGERY LLC

Contact Information

Specialty

Plastic and Reconstructive Surgery

NPI Profile & details for ANDREW MANDERY MD PLASTIC SURGERY LLC

Reviews for ANDREW MANDERY MD PLASTIC SURGERY LLC