Provider Demographics
NPI:1396744181
Name:MANOCHA, MARKESH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:MARKESH
Middle Name:KUMAR
Last Name:MANOCHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6292
Mailing Address - Country:US
Mailing Address - Phone:912-354-4800
Mailing Address - Fax:912-629-5821
Practice Address - Street 1:4720 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6292
Practice Address - Country:US
Practice Address - Phone:912-354-4800
Practice Address - Fax:912-629-5821
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA040475207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000729374HMedicaid
GA000729374MMedicaid
GA000729374GMedicaid
GA000729374NMedicaid
GA000729374PMedicaid
GA748654OtherBCBS JESUP
GA000729374IMedicaid
GA000729374JMedicaid
GA000729374OMedicaid
GA180041924OtherRR MEDICARE
SCG40475Medicaid
GA000729374KMedicaid
GA865250OtherBCBS STATESBORO
GA748653OtherBCBS SAVANNAH
GAP00775824OtherRR MEDICARE
GA748652OtherHINESVILLE
G35535Medicare UPIN
GA18BDFVRMedicare ID - Type Unspecified
GA748654OtherBCBS JESUP