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NPI Code Detail

MEDICARE: DR. CYNTHIA KAISER MANOS M.D.

MEDICARE: DR. CYNTHIA KAISER MANOS M.D.
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
12080P0216XPediatric Rheumatology PhysicianMT205493PA
2390200000XStudent in an Organized Health Care Education/Training Program
32080P0216XPediatric Rheumatology Physician77850GA

General Provider Information

NPI Number : 1609168483
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA KAISER MANOS M.D.
Provider Business Mailing Address
First Line : 2174 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329-3102
Country : US
Telephone Number : 404-785-5437
Fax Number : 404-785-9096
Provider Business Practice Location Address
First Line : 2147 N DRUID HILLS RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30329
Country : US
Telephone Number : 404-785-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2011
Last Update Date : 01/26/2024

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