Provider Demographics
NPI:1265500698
Name:MANNEPULI, GIRI BABU (MD)
Entity Type:Individual
Prefix:
First Name:GIRI
Middle Name:BABU
Last Name:MANNEPULI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 N 5TH STREET HWY
Mailing Address - Street 2:READING CONVENIENT CARE
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605
Mailing Address - Country:US
Mailing Address - Phone:610-939-1532
Mailing Address - Fax:610-939-1535
Practice Address - Street 1:3535 N 5TH STREET HWY
Practice Address - Street 2:READING CONVENIENT CARE
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605
Practice Address - Country:US
Practice Address - Phone:610-939-1532
Practice Address - Fax:610-939-1535
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD062948L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H06822Medicare UPIN
PA033136QYFMedicare PIN