Individual
DR. MANUEL M FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3369 BUFORD HWY NE STE 810, ATLANTA, GA 30329-3722
(404) 326-4692
(678) 482-8393
Mailing address
3369 BUFORD HWY NE STE 810, ATLANTA, GA 30329-3722
(404) 321-4692
(678) 482-8393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
011753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000271609F
—
GA
Enumeration date
01/25/2007
Last updated
09/25/2009
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