Organization
CUMMING RHEUMATOLOGY AND ARTHRITIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAGINDRA NATH MANGRU M.D. (PHYSICIAN)
(770) 887-5159
Entity
Organization
Contact information
Practice address
3970 DEPUTY BILL CANTRELL MEM, STE 203, CUMMING, GA 30040-3004
(770) 887-5159
(770) 887-9496
Mailing address
3970 DEPUTY BILL CANTRELL MEM, STE 203, CUMMING, GA 30040-5962
(770) 887-5159
(770) 887-9496
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
62253
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
560855484A
—
GA
Enumeration date
09/27/2010
Last updated
01/21/2020
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