Individual
DR. KAVITA RANI KONGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1600, ATLANTA, GA 30308-2212
(404) 881-1094
(404) 874-1249
Mailing address
1955 LAKE PARK DR SE, SUITE 250, SMYRNA, GA 30080-8858
(678) 223-7726
(678) 388-1759
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
063678
GA
207RG0100X
Gastroenterology Physician
197035
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02040297
—
NY
01
—
202I105712
MEDICARE
GA
05
—
768114952
—
GA
Enumeration date
03/14/2006
Last updated
01/17/2017
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