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Individual

MANJULA BANGALORE KALLUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.,

Contact information

Practice address
3807 CLIAIRMONT ROAD NE, CHAMBLEE, GA 30341
(770) 457-5867
Mailing address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 294-3836

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
057126
GA
2084P0805X
Geriatric Psychiatry Physician
057126
GA

Other

Enumeration date
11/28/2007
Last updated
04/18/2017
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