Individual
DR. MANA L KASONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3270
(229) 276-3325
(229) 276-3322
Mailing address
902 N 7TH ST, CORDELE, GA 31015-3270
(229) 276-3325
(229) 276-3322
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
057753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
356927
WELLCARE
GA
01
—
52202589
BCBS
GA
01
—
52202589-004
BCBS
GA
05
—
682562580A
—
GA
05
—
682562580B
—
GA
05
—
682562580C
—
GA
01
—
P00351740
RAILROAD MEDICARE
GA
Enumeration date
06/01/2006
Last updated
03/05/2021
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