Basic Information
| Provider Information | |||||||||
| NPI: | 1518488253 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MANCHIKALAPATI | ||||||||
| FirstName: | ANANYA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 5TH AVE S STE 102 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352331700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056389387 | ||||||||
| FaxNumber: | 2059756505 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 5TH AVE S STE 102 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352331700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056389387 | ||||||||
| FaxNumber: | 2059756505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2017 | ||||||||
| LastUpdateDate: | 08/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD.41056 | AL | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0203X | MD.41056 | AL | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Critical Care Medicine |
No ID Information.