Provider Demographics
NPI:1396732376
Name:MANOCHA, MONICA B (MD)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:B
Last Name:MANOCHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:5102 PAULSEN ST
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4601
Mailing Address - Country:US
Mailing Address - Phone:912-354-5814
Mailing Address - Fax:912-691-0923
Practice Address - Street 1:5102 PAULSEN ST
Practice Address - Street 2:BUILDING 3
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4601
Practice Address - Country:US
Practice Address - Phone:912-354-5814
Practice Address - Fax:912-691-0923
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2011-11-17
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Provider Licenses
StateLicense IDTaxonomies
GA042348208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00716405BMedicaid
GA00716405AMedicaid