Individual
DR. MANISH SURESH NOTICEWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8901 STONEBRIDGE BLVD STE 200, DOUGLASVILLE, GA 30134-2244
(943) 202-7030
(470) 986-7021
Mailing address
8901 STONEBRIDGE BLVD STE 200, DOUGLASVILLE, GA 30134-2244
(943) 202-7030
(470) 986-7021
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
295921
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
295921
NY
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
93579
GA
Other
Enumeration date
04/25/2012
Last updated
11/14/2022
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