Mani Mokalla, MD | |
5200 Fairview Blvd, Wyoming, MN 55092-8013 | |
(651) 982-7000 | |
Not Available |
Full Name | Mani Mokalla |
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Gender | Male |
Speciality | Pediatrics |
Location | 5200 Fairview Blvd, Wyoming, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043243041 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 47244 (Minnesota) | Primary |
Entity Name | Children's Health Care |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1932208808 PECOS PAC ID: 2668370966 Enrollment ID: O20040406000939 |
Mailing Address | Practice Location Address |
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Mani Mokalla, MD 3436 18th Ave S, Minneapolis, MN 55407-2327 Ph: () - | Mani Mokalla, MD 5200 Fairview Blvd, Wyoming, MN 55092-8013 Ph: (651) 982-7000 |
Sarah Connaughty Fuerstenberg, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Benjamin Stanghelle, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Kevin Anthony Brueske, Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 | |
Scott Ward Ahrenholz, D.O. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7800 Fax: 651-982-7539 | |
Sarah Barnes Kinsella, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7600 | |
Dr. Amy Beth Vislisel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5200 Fairview Blvd, Wyoming, MN 55092 Phone: 651-982-7000 |