Basic Information
| Provider Information | |||||||||
| NPI: | 1962483602 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MOTAPARTHI | ||||||||
| FirstName: | MANJARI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 950202 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402950202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 3991 DUTCHMANS LN STE 300 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402074700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028896782 | ||||||||
| FaxNumber: | 5028996783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2005 | ||||||||
| LastUpdateDate: | 05/03/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 01061427 | IN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 40998 | KY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 000000553249 | 01 | KY | ANTHEM - NNS | OTHER | 196290DDDD | 01 | IN | MEDICARE - NNS | OTHER | 64119290 | 05 | KY | MEDICAID | 088968 | 01 | KY | SIHO - NNS | OTHER | 1606069 | 01 | KY | CIGNA - NNS | OTHER | 000023032V | 01 | KY | HUMANA - NNS | OTHER | 094759 | 01 | KY | SIHO - CMA | OTHER | 200838970 | 05 | IN | MEDICAID | 50020053 | 01 | KY | PASSPORT - NNS | OTHER |