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Individual

MANJUSHREE GHOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1595 CLEVELAND AVE, EAST POINT, GA 30344-3200
(404) 616-2886
(404) 209-1769
Mailing address
75 PIEDMONT AVE, SUITE 700, ATLANTA, GA 30303-2544
(404) 616-1776
(404) 241-7162

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
042827
GA
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
042827
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00821631
GA
Enumeration date
07/26/2005
Last updated
10/07/2011
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