Individual
NITASHA MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4800 OLDE TOWNE PKWY, SUITE 350, MARIETTA, GA 30068-4357
(404) 303-1224
(404) 303-1325
Mailing address
5780 PEACHTREE DUNWOODY RD, SUITE 300, ATLANTA, GA 30342-1554
(404) 303-1224
(404) 303-1325
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
76364
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177423A
—
GA
Enumeration date
05/23/2012
Last updated
10/12/2020
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