Provider Demographics
NPI:1063783454
Name:NEPAL, MANOJ KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MANOJ
Middle Name:KUMAR
Last Name:NEPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:14 RICHLAND MEDICAL PARK DR STE 400
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6878
Practice Address - Country:US
Practice Address - Phone:803-434-7945
Practice Address - Fax:803-434-3855
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP8705208000000X
SC85689208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC856899Medicaid
NY932038OtherSUNY DOWNSTATE MEDICAL CENTER
PAMD446172OtherPA LICENSE
TXP8705OtherTEXAS MEDICAL LICENSE NUMBER