KIRAN A MANGALAM


Address: 149 North St, Waterville, ME 04901-4974
Phone: 2078615101

KIRAN A MANGALAM (NPI# 1528175312) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1528175312
Entity Type Individual
Full Name KIRAN A MANGALAM
Credential DO
Practice Address 149 North St
Waterville
ME 04901-4974
Practice Telephone 2078615101
Practice Fax Number 2078724341
Mailing Telephone 2078615101
Mailing Fax Number 2078724341
Enumeration Date 2006-08-25
Last Update Date 2019-05-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 204D00000X Neuromusculoskeletal Medicine & OMM 2144 ME Allopathic & Osteopathic Physicians
N 207Q00000X Family Medicine 2144 ME Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
ME 432682599 05
MEDICARE ID - GROUP MM7302 01

Office Location

Street Address 149 NORTH ST
City WATERVILLE
State ME
Zip Code 04901-4974

Providers in the same location

NPI Name Taxonomy Address Enumeration
1083691869 Robin M Wood Nuclear Medicine 149 North St, Waterville, ME 04901-4974 2005-12-22
1588289961 Kellee Gorgone Nurse Practitioner 149 North St, Waterville, ME 04901-4974 2020-06-11
1962027656 Thomas Pentzer Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2020-06-09
1437774122 Anita Nwanna-nzewunwa Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2020-06-09
1487279162 Jesse Leeds Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2020-06-09
1093366239 Danielle Rice Nurse Practitioner 149 North St, Waterville, ME 04901-4974 2019-09-27
1528627080 Lisa Smith Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2019-06-10
1215596762 Rose Knudsen Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2019-06-09
1053970509 Lara Householder Student in an Organized Health Care Education/Training Program 149 North St, Waterville, ME 04901-4974 2019-06-09
1033694807 Elizabeth Harwood Nurse Practitioner 149 North St, Waterville, ME 04901-4974 2018-09-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093325649 Orthopedic Physical Therapy Physical Therapist Orthopedic Physical Therapy, 234 College Ave, Waterville, ME 04901 2020-08-07
1790328771 Elizabeth Saucier Counselor Discovery House 40 Airport Rd, Waterville, ME 04901 2019-10-23
1780233445 Amy Marie Tardy Counselor 325 Kmd, Building D - Unit 4, 325 Kmd - Building D -- Unit 4, Waterville, ME 04901 2019-09-05
1457905911 Waterville Audiology PC Audiologist-Hearing Aid Fitter 124 Silver Street, Waterville, ME 04901 2019-08-01
1629537048 Samantha Sobel Behavioral Analyst 2 Seton Center Dr, Waterville, ME 04901 2019-03-15
1366916025 Waterville Pharmacy Pharmacy 20 Concourse W, Waterville, ME 04901 2019-01-16
1699243733 Thomas James Demers Counselor Discovery House, 40 Airport Road, Waterville, ME 04901 2018-11-07
1851892442 Alishia M Austin Counselor Discovery House Ctc Waterville 40 Airport Rd, Waterville, ME 04901 2018-02-28
1336671056 Douglas Joseph Dicola Family Medicine Mainegeneral Medical Center, 149 North St, Waterville, ME 04901 2017-03-31
1134660020 Waterville Medical Supplies Durable Medical Equipment & Medical Supplies 325 Waterville Commons Drive, Waterville, ME 04901 2017-03-13
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Taxonomy Information

Taxonomy Code 204D00000X
Grouping Allopathic & Osteopathic Physicians
Classification Neuromusculoskeletal Medicine & OMM

Taxonomy Definition

The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients.
Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition]
- Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417336603 William Cochran Mcdougall Iv Neuromusculoskeletal Medicine & OMM 149 North St, Waterville, ME 04901-4974 2015-05-21
1831537109 Samuel Madore Neuromusculoskeletal Medicine & OMM 149 North St, Waterville, ME 04901-4974 2013-06-10
1164475794 Mark Erin Sutherland Neuromusculoskeletal Medicine & OMM 149 North St, Waterville, ME 04901-4974 2006-05-17

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1417428848 David D Keller Do PC Neuromusculoskeletal Medicine & OMM 195 Fore River Pkwy Ste 470, Portland, ME 04102-2787 2018-12-11
1659715738 Maine Osteopathic Medicine, LLC Neuromusculoskeletal Medicine & OMM 146 Ocean St, Suite 2, South Portland, ME 04106-3664 2013-04-19
1114161874 Timothy Christopher Kulikowski Neuromusculoskeletal Medicine & OMM 915 Union St Ste 4, Bangor, ME 04401-8603 2009-04-26
1720242357 Daniel S Gibbons Neuromusculoskeletal Medicine & OMM 23 Durham Rd Ste 101, Freeport, ME 04032-6796 2008-07-14
1285896514 Jennifer Lee Lakis Neuromusculoskeletal Medicine & OMM 14 Maine St # 14, Brunswick, ME 04011-2049 2008-06-27
1003006271 Karen M Benezra Neuromusculoskeletal Medicine & OMM 62 Portland Rd Ste 21, Kennebunk, ME 04043-6650 2007-07-25
1508065210 Joshua Iannetta Neuromusculoskeletal Medicine & OMM 632 Us Route 1, Scarborough, ME 04074-9794 2007-07-12
1265579015 Bonnie Joan Sendzicki Neuromusculoskeletal Medicine & OMM 81 Blackguard Road, Waterford, ME 04088 2007-01-31
1760531180 Christine Blake Smith Neuromusculoskeletal Medicine & OMM 114 Stroudwater St, Westbrook, ME 04092-4037 2007-01-09
1003984311 Charles W Sullivan Neuromusculoskeletal Medicine & OMM 98 Second St, Hallowell, ME 04347-1368 2006-12-04
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Competitor

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City WATERVILLE
Zip Code 04901

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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