Healthcare Provider Details

I. General information

NPI: 1376730408
Provider Name (Legal Business Name): MANUEL DAMIAN RODRIGUEZ D.O.,M.S., M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 PEACHTREE DUNWOODY RD STE 330
SANDY SPRINGS GA
30342-5023
US

IV. Provider business mailing address

5673 PEACHTREE DUNWOODY RD STE 330
SANDY SPRINGS GA
30342-5023
US

V. Phone/Fax

Practice location:
  • Phone: 404-459-0002
  • Fax: 404-459-0003
Mailing address:
  • Phone: 404-459-0002
  • Fax: 404-459-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number69433
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: