Individual
MADHURYA PAVANI MULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO, MPH
Contact information
Practice address
777 HEMLOCK ST, MACON, GA 31201-2102
(478) 633-1000
Mailing address
777 HEMLOCK ST # 165, MACON, GA 31201-2102
(478) 633-1000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
15117
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/31/2020
Last updated
08/11/2023
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