Provider Demographics
NPI:1487844353
Name:MANI, SWARNAMBAL (MD)
Entity Type:Individual
Prefix:DR
First Name:SWARNAMBAL
Middle Name:
Last Name:MANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:367 KRISTIN CT E
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3584
Mailing Address - Country:US
Mailing Address - Phone:262-244-7099
Mailing Address - Fax:
Practice Address - Street 1:367 KRISTIN CT E
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-3584
Practice Address - Country:US
Practice Address - Phone:262-244-7099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33088207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIF31148Medicare UPIN