Mani, Balu S

Mani, Balu S is an individual health care provider with primary practice located at 119 Upper Riverdale Rd Sw , Riverdale GA 30274-2540. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Mani, Balu S can be contacted via phone (770) 991-1010.

Contact Information

Primary practice address
119 Upper Riverdale Rd Sw Riverdale GA 30274-2540
Phone: (770) 991-1010
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036920 Georgia

Profile Details

NPI number 1467439612
LBN Legal business name Mani, Balu S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Mar 11th, 2011 - about 13 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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Identifiers

StateTypeNumberIssuer
All States NPI 1467439612 NPPES
Georgia MEDICAID 000544893

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