Organization
RIKA MEDICAL CLINIC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI MANCHIREDDY (PRACTICE MANAGER)
(678) 205-1959
Entity
Organization
Contact information
Practice address
6131 S NORCROSS TUCKER RD, SUITE E600, NORCROSS, GA 30093-5536
(678) 205-1959
(678) 205-2092
Mailing address
150 MEDICAL BLVD, SUITE C, STOCKBRIDGE, GA 30281-5053
(678) 289-4901
(678) 289-4942
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
026530
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000639834AC
—
GA
Enumeration date
06/12/2012
Last updated
06/12/2012
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