Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MAMATHA MOODALAGIRIAIAH, M.D
Active Sole ProprietorDR. MAMATHA MOODALAGIRIAIAH, M.D is a Obstetrics healthcare provider located in DECATUR, Illinois. NPI 1891058566 is currently active in the NPPES registry. Verify at CMS.
Obstetrics · DECATUR, IL
Registration Details
- NPI Number
- 1891058566
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 19, 2012 (14.153217241424 yrs)
- Last Updated
- Aug 9, 2013
- License
-
036-133305 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1 MEMORIAL DRSUITE 300DECATUR, IL, 625266303Browse IL providers · Browse ZIP 62526
- Phone
- 2178722400
- Fax
- 2178754680
- Primary Specialty
-
Obstetrics
207VX0000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.