Provider Demographics
NPI:1255390829
Name:KENNEY, MONICA RAMA (M D)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:RAMA
Last Name:KENNEY
Suffix:
Gender:F
Credentials:M D
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:
Other - Last Name:RAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:505 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2668
Mailing Address - Country:US
Mailing Address - Phone:912-354-6190
Mailing Address - Fax:912-354-6172
Practice Address - Street 1:505 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2668
Practice Address - Country:US
Practice Address - Phone:912-354-6190
Practice Address - Fax:912-354-6172
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA54929207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA467188176AMedicaid
SCG54929Medicaid
703341OtherBLUECROSS BLUE SHIELD
GAP00263212OtherRAILROAD MEDICARE
GA467188176AMedicaid
GAI12927Medicare UPIN