MEDICARE: GEETHA MANCHIREDDY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	50585	GA

General Provider Information

NPI Number	:	1730157488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETHA MANCHIREDDY MD

Provider Business Mailing Address
First Line	:	2950 STONE HOGAN CONNECTOR RD SW
Second Line	:	BUILDING A SUITE B
City	:	ATLANTA
State	:	GA
Zip	:	30331-2837
Country	:	US
Telephone Number	:	678-289-4901
Fax Number	:	678-289-4942

Provider Business Practice Location Address
First Line	:	2950 STONE HOGAN CONNECTOR RD SW
Second Line	:	BUILDING A SUITE B
City	:	ATLANTA
State	:	GA
Zip	:	30331-2837
Country	:	US
Telephone Number	:	678-289-4901
Fax Number	:	678-289-4942

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	02/23/2015

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