Organization
GEETHA MANCHIREDDY M.D. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAVI REDDY CFO (CORPORATE FINANCIAL OFFICER)
(678) 289-4901
Entity
Organization
Contact information
Practice address
150 MEDICAL BLVD, STE C, STOCKBRIDGE, GA 30281-5053
(678) 289-4901
(678) 289-4942
Mailing address
150 MEDICAL BLVD, STE C, STOCKBRIDGE, GA 30281-5053
(678) 289-4901
(678) 289-4942
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
050585
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000943533B
—
GA
01
—
05BDHXF
MEDICARE NUMBER
GA
Enumeration date
08/30/2012
Last updated
08/30/2012
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