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Individual

DR. MANOJ KUMAR REDDY AMBUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.B.B.S

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-1007
(706) 721-8623
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-8623

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
R8499
IA
207T00000X
Neurological Surgery Physician
SP-207
IA
2085N0700X
Neuroradiology Physician
Primary
89014
GA
2085R0202X
Diagnostic Radiology Physician
35.154412
OH
2085R0202X
Diagnostic Radiology Physician
89014
GA
2085R0202X
Diagnostic Radiology Physician
TP619
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
89014
GA MEDICAL LICENSE
GA
Enumeration date
07/01/2009
Last updated
08/28/2025
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