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Individual

TIFFANY MANGAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
350 WINN WAY, DECATUR, GA 30030-2106
(703) 534-1000
(404) 508-9640
Mailing address
350 WINN WAY, DECATUR, GA 30030-2106
(404) 508-1177

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
84873
GA

Other

Enumeration date
04/07/2014
Last updated
08/08/2023
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