Provider Demographics
NPI:1598902140
Name:GADDH, MANILA (MD)
Entity Type:Individual
Prefix:
First Name:MANILA
Middle Name:
Last Name:GADDH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:SUITE C 1152
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-5871
Mailing Address - Fax:404-778-4755
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:SUITE C 1152
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-5871
Practice Address - Fax:404-778-4755
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-18
Last Update Date:2012-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA67418207RH0000X
IL036.122544207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine