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Individual

DR. JOHN A MANFREDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
308 DEEP SOUTH FARM RD, SUITE 200, BLAIRSVILLE, GA 30512-2218
(706) 835-2235
(706) 835-1706
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(678) 288-9555
(678) 288-9556

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
16101
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000011382K
GA
05
000011382M
GA
Enumeration date
08/15/2005
Last updated
04/09/2015
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