Individual
MANOJ VENKAT MADDALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 COLLIER RD NW STE 300, ATLANTA, GA 30309-1740
(404) 350-0009
Mailing address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A159406
CA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
104968
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
A159406
CA
207RP1001X
Pulmonary Disease Physician
104968
GA
207RP1001X
Pulmonary Disease Physician
A159406
CA
Other
Enumeration date
02/02/2015
Last updated
09/03/2025
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