Provider Demographics
NPI:1932405990
Name:MUS CENTER OF GEORGIA
Entity Type:Organization
Organization Name:MUS CENTER OF GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA
Authorized Official - Prefix:
Authorized Official - First Name:GEETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANCHIREDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-932-6172
Mailing Address - Street 1:2950 STONE HOGAN CONNECTOR RD SW
Mailing Address - Street 2:BLDG A, STE B
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5053
Mailing Address - Country:US
Mailing Address - Phone:404-781-2900
Mailing Address - Fax:404-781-2903
Practice Address - Street 1:150 MEDICAL BLVD
Practice Address - Street 2:STE C
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-2837
Practice Address - Country:US
Practice Address - Phone:404-932-6172
Practice Address - Fax:678-289-4942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty