MEDICARE: HARI KIRAN DIGUMARTHI DMD, 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN013558	GA

General Provider Information

NPI Number	:	1821291816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARI KIRAN DIGUMARTHI DMD, MD

Provider Business Mailing Address
First Line	:	619 CHAMPIONS DR
Second Line	:
City	:	MCDONOUGH
State	:	GA
Zip	:	30253-4284
Country	:	US
Telephone Number	:	404-788-6399
Fax Number	:

Provider Business Practice Location Address
First Line	:	3280 HOWELL MILL RD NW STE 221
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4100
Country	:	US
Telephone Number	:	404-892-2999
Fax Number	:

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

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	12/19/2022

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