Provider Demographics
NPI:1134539463
Name:RANA K MUNNA MD LLC
Entity type:Organization
Organization Name:RANA K MUNNA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MUNNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-238-0771
Mailing Address - Street 1:330 HOSPITAL DR
Mailing Address - Street 2:BUILDING C SUITE 302
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31217-3899
Mailing Address - Country:US
Mailing Address - Phone:478-238-0771
Mailing Address - Fax:478-238-6688
Practice Address - Street 1:330 HOSPITAL DR
Practice Address - Street 2:BUILDING C SUITE 302
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3899
Practice Address - Country:US
Practice Address - Phone:478-238-0771
Practice Address - Fax:478-238-6688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty