Provider Demographics
NPI:1821291816
Name:DIGUMARTHI, HARI KIRAN (DMD, MD)
Entity Type:Individual
Prefix:
First Name:HARI
Middle Name:KIRAN
Last Name:DIGUMARTHI
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 CHAMPIONS DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4284
Mailing Address - Country:US
Mailing Address - Phone:404-788-6399
Mailing Address - Fax:
Practice Address - Street 1:3280 HOWELL MILL RD NW STE 221
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-4100
Practice Address - Country:US
Practice Address - Phone:404-892-2999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0135581223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery