Mangaroo, Shantae

Mangaroo, Shantae is an sole proprietor health care provider with primary practice located at 8011 Mall Pkwy , Lithonia GA 30038. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Mangaroo, Shantae can be contacted via phone (404) 518-8056.

Contact Information

Primary practice address
8011 Mall Pkwy Lithonia GA 30038
Phone: (404) 518-8056
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 80684 Georgia

Profile Details

NPI number 1902293434
LBN Legal business name Mangaroo, Shantae
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 22nd, 2015
Last updated Apr 14th, 2022 - about 3 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.

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