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Individual

DR. MANOHAR N NALLATHAMBI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., F.A.C.S.

Contact information

Practice address
1040 EAGLES LANDING PKWY, SUITE100, STOCKBRIDGE, GA 30281-9072
(770) 474-7287
(770) 389-3713
Mailing address
1040 EAGLES LANDING PKWY, SUITE100, STOCKBRIDGE, GA 30281-9072
(770) 474-7287
(770) 389-3713

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
029356
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00341998C
GA
Enumeration date
10/07/2005
Last updated
07/14/2016
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