Individual
MANOJNA P SANJEEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
380 HOSPITAL DRIVE, SUITE 410, MACON, GA 31217
(478) 746-5644
(478) 745-4849
Mailing address
PO BOX 2564, MACON, GA 31203
(478) 746-5644
(478) 745-4849
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
046639
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000822379F
—
GA
05
—
000822379H
—
GA
05
—
000822379I
—
GA
05
—
000822379J
—
GA
01
—
326776
WELLCARE
GA
01
—
P00059300
RAILROAD MEDICARE
GA
Enumeration date
08/04/2006
Last updated
06/04/2013
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