Individual
FATIMAH MANZOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3834
(770) 535-0191
(770) 535-0916
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
064600
GA
207R00000X
Internal Medicine Physician
6241
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003100463A
—
GA
01
—
01401428
AMERIGROUP
GA
01
—
1700011
CIGNA
GA
01
—
52497649
BCBS
GA
01
—
588865
WELLCARE
GA
01
—
P00903602
MEDICARE RAILROAD
GA
Enumeration date
05/01/2007
Last updated
07/22/2011
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