Individual
DR. PRAYA MAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4877 BILL GARDNER PKWY, LOCUST GROVE, GA 30248
(404) 363-9944
(678) 432-7040
Mailing address
425 FOREST PKWY, SUITE 101, FOREST PARK, GA 30297-2185
(404) 363-9944
(404) 363-9951
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
00723
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00614105A
—
GA
Enumeration date
12/23/2005
Last updated
07/23/2018
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