Provider Demographics
NPI:1417980558
Name:MANEKAR, JYOTI (MD)
Entity Type:Individual
Prefix:DR
First Name:JYOTI
Middle Name:
Last Name:MANEKAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JYOTI
Other - Middle Name:MADHUKARRAO
Other - Last Name:NAIKUDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3790 PLEASANT HILL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5150
Mailing Address - Country:US
Mailing Address - Phone:678-312-6200
Mailing Address - Fax:678-312-6226
Practice Address - Street 1:3790 PLEASANT HILL RD STE 250
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5150
Practice Address - Country:US
Practice Address - Phone:678-312-6200
Practice Address - Fax:678-312-6226
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA57099207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA577079261BMedicaid
GA7144975OtherAETNA
GA5240401P01OtherCIGNA
GA793647OtherHUMANA
GA2653535OtherUNITED HEALTH CARE
GA332767OtherWELLCARE OF GEORGIA
GA08CBCNJOtherMEDICARE PART B
GA52209884-001OtherBCBS OF GEORGIA
GA7144975OtherAETNA