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Individual

MANOGNA MADDINENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
677 CHURCH ST NE # 111, MARIETTA, GA 30060-1101
(770) 793-7750
Mailing address
8954 HOSPITAL DRIVE, DOUGLASVILLE, GA 30134
(678) 838-2585

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
063369
GA
208M00000X
Hospitalist Physician
Primary
06549
GA

Other

Enumeration date
05/07/2007
Last updated
10/11/2019
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