Individual
MANISHA JAKKIDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1117 20TH ST, COLUMBUS, GA 31901-1848
(063) 246-3657
Mailing address
PO BOX 117337, ATLANTA, GA 30368-7337
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
86981
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/09/2015
Last updated
01/12/2022
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