Provider Demographics
NPI:1790984003
Name:MANGALMURTI, SARANG SHRIHARI (MD)
Entity Type:Individual
Prefix:DR
First Name:SARANG
Middle Name:SHRIHARI
Last Name:MANGALMURTI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:825 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3200
Mailing Address - Country:US
Mailing Address - Phone:610-527-1165
Mailing Address - Fax:610-527-6611
Practice Address - Street 1:825 OLD LANCASTER RD
Practice Address - Street 2:SUITE 320
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3200
Practice Address - Country:US
Practice Address - Phone:610-527-1165
Practice Address - Fax:610-527-6611
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD430414207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023236200005Medicaid
PA1023236200005Medicaid