Provider Demographics
NPI:1881701928
Name:MANN, JYOTHI NAT (MD)
Entity type:Individual
Prefix:DR
First Name:JYOTHI
Middle Name:NAT
Last Name:MANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1593 YANCEYVILLE ST BLDG A
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-6948
Mailing Address - Country:US
Mailing Address - Phone:336-275-1306
Mailing Address - Fax:336-275-1307
Practice Address - Street 1:1593 YANCEYVILLE ST BLDG A
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-6948
Practice Address - Country:US
Practice Address - Phone:336-275-1306
Practice Address - Fax:336-275-1307
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC9300399207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2902588OtherUNITED HEALTHCARE
NC561999974OtherTAX ID
NC7961878Medicaid
NC288646OtherMAMSI
NC5126228OtherFIRST HEALTH
NC61878OtherBCBS
NC4453277OtherAETNA
NC68576OtherMEDCOST
NC110151769OtherRAILROAD MEDICARE
NC7779OtherPARTNERS
NC2902588OtherUNITED HEALTHCARE
NC561999974OtherTAX ID