Individual
MANJARI MUKKAMALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
35 COLLIER RD NW, SUITE 635, ATLANTA, GA 30309-1613
(404) 367-3014
(404) 367-3558
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
(404) 367-3014
(404) 367-3558
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
058546
GA
208M00000X
Hospitalist Physician
Primary
058546
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291833010B
—
GA
01
—
P00477935
RR MEDICARE
GA
Enumeration date
09/22/2006
Last updated
04/22/2010
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