Individual
DR. PAVAN KUMAR MAMILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
11379 SOUTHBRIDGE PKWY STE A, ALPHARETTA, GA 30022-4402
(770) 777-0750
(770) 777-0521
Mailing address
11379 SOUTHBRIDGE PKWY STE A, ALPHARETTA, GA 30022-4402
(770) 777-0750
(770) 777-0521
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
79227
GA
207Q00000X
Family Medicine Physician
MD.33421
AL
Other
Enumeration date
07/29/2009
Last updated
11/02/2023
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