Provider Demographics
NPI:1235514936
Name:MANDADI, NATISHA (DO)
Entity Type:Individual
Prefix:DR
First Name:NATISHA
Middle Name:
Last Name:MANDADI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 CROOKED CREEK PKWY STE 420
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-8507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:919-385-7536
Practice Address - Street 1:234 CROOKED CREEK PKWY STE 420
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-8507
Practice Address - Country:US
Practice Address - Phone:919-385-3000
Practice Address - Fax:919-385-7536
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-23
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2019-015952084N0400X
MI5101220662084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology