Provider Demographics
NPI:1881976785
Name:MANNERI, HIMABINDU (MD)
Entity type:Individual
Prefix:
First Name:HIMABINDU
Middle Name:
Last Name:MANNERI
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 1:112 AVON CT
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-8526
Mailing Address - Country:US
Mailing Address - Phone:443-653-9453
Mailing Address - Fax:
Practice Address - Street 1:7355 E FURNACE BRANCH RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-7060
Practice Address - Country:US
Practice Address - Phone:410-766-3460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD040743207R00000X, 208M00000X
MDD54401208M00000X
MDD84401207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist