Provider Demographics
NPI:1568663144
Name:MONDAY, LAWANNA K (DPM)
Entity Type:Individual
Prefix:
First Name:LAWANNA
Middle Name:K
Last Name:MONDAY
Suffix:
Gender:F
Credentials:DPM
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Mailing Address - Street 1:1350 UPPER HEMBREE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-0929
Mailing Address - Country:US
Mailing Address - Phone:678-426-2171
Mailing Address - Fax:404-446-1957
Practice Address - Street 1:5700 HILLANDALE DR STE 220
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30058-4103
Practice Address - Country:US
Practice Address - Phone:404-288-4117
Practice Address - Fax:404-288-8451
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2022-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GAPOD001038213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA7835981OtherAETNA
GA416339OtherWELLCARE
GA922417859LMedicaid
GA1597926OtherAETNA
GA922417859BMedicaid
GA7835981OtherAETNA
GA922417859BMedicaid
GA$$$$$$$$$OtherTRICARE
GA7835981OtherAETNA