Organization
THE CHILDREN'S MEDICAL GROUP OF GREENVILLE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOSAN MENANYA AZOMANI MD (MANAGER)
(662) 334-9915
Entity
Organization
Contact information
Practice address
559 ARNOLD AVE STE A, GREENVILLE, MS 38701-5323
(662) 334-9915
(662) 334-9740
Mailing address
PO BOX 1735, GREENVILLE, MS 38702-1735
(662) 334-9915
(662) 334-9740
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18728
MS
Other
Enumeration date
10/15/2007
Last updated
06/01/2008
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