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Individual

LAWRENCE B. MANALO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2209
(706) 721-7319
Mailing address
1542 TULANE AVE, DEPARTMENT OF RADIOLOGY, NEW ORLEANS, LA 70112-2865
(504) 568-4647

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
103919
GA
2085R0202X
Diagnostic Radiology Physician
MD.206240
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2196448
LA
Enumeration date
04/07/2012
Last updated
04/07/2026
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