Provider Demographics
NPI:1023210895
Name:PIRI, MANUEL (NP)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:
Last Name:PIRI
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 MULKEY RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-1170
Mailing Address - Country:US
Mailing Address - Phone:678-838-6600
Mailing Address - Fax:678-838-6602
Practice Address - Street 1:1676 MULKEY RD
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1170
Practice Address - Country:US
Practice Address - Phone:678-838-6600
Practice Address - Fax:678-838-6602
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN154748363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner