Provider Demographics
NPI:1851451595
Name:MANGAS, STEVEN C (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:MANGAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6699 ROCKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3926
Mailing Address - Country:US
Mailing Address - Phone:317-247-1717
Mailing Address - Fax:317-247-7704
Practice Address - Street 1:6699 ROCKVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3926
Practice Address - Country:US
Practice Address - Phone:317-247-1717
Practice Address - Fax:317-247-7704
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000996A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100227610AMedicaid
INT35032Medicare UPIN
IN100227610AMedicaid