Individual
DR. INDIRA GM MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1457 SCOTT BLVD, DECATUR, GA 30030
(404) 292-2500
(404) 294-9361
Mailing address
PO BOX 1798, DECATUR, GA 30031-1798
(404) 292-2500
(404) 294-9361
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
047623
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00837284A
—
GA
Enumeration date
08/02/2005
Last updated
07/08/2007
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