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Organization
CUMMING RHEUMATOLOGY AND ARTHRITIS LLC
Active
Organization
CUMMING RHEUMATOLOGY AND ARTHRITIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAGINDRA NATH MANGRU M.D. (PHYSICIAN)
(770) 887-5159
Entity
Organization
Contact information
Practice address
3970 DEPUTY BILL CANTRELL MEM, STE 203, CUMMING, GA 30040-3004
(770) 887-5159
(770) 887-9496
Mailing address
3970 DEPUTY BILL CANTRELL MEM, STE 203, CUMMING, GA 30040-5962
(770) 887-5159
(770) 887-9496
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
62253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
560855484A
—
GA
Enumeration date
09/27/2010
Last updated
01/21/2020
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