Pakkala, Manjit
Pakkala, Manjit is an individual health care provider with primary practice located at 1255 Highway 54 W , Fayetteville GA 30214-4526. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Pakkala, Manjit can be contacted via phone (404) 367-3014.Contact Information
Primary practice address
1255 Highway 54 W
Fayetteville GA 30214-4526
Phone: (404) 367-3014
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2015021659 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 005442 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 0439088 | Kansas |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 73446 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 2015021659 | Missouri |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 73446 | Georgia |
Profile Details
| NPI number | 1821358003 |
|---|---|
| LBN Legal business name | Pakkala, Manjit |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 22nd, 2012 |
| Last updated | Aug 25th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821358003 | NPPES |
| Kansas | MEDICAID | 201125270A | |
| Kansas | Other | P01527145 | |
| Kansas | MEDICAID | 1821358003 | |
| Kansas | MEDICAID | 1821358003 |
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