Individual
DR. PRAVEEN MANNAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
3511 W MARKET ST STE 100, GREENSBORO, NC 27403-4444
(336) 522-8999
(336) 522-8998
Mailing address
PO BOX 745040, ATLANTA, GA 30374-5040
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2016-00544
NC
207RP1001X
Pulmonary Disease Physician
Primary
2016-00544
NC
Other
Enumeration date
05/05/2008
Last updated
12/10/2024
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