| Arun K Kantamneni Md, Inc. | |
|
20 Herrell Rd Villa Rica GA 30180-5527 | |
| (770) 881-8495 | |
| Not Available |
| Full Name | Arun K Kantamneni Md, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 20 Herrell Rd, Villa Rica, Georgia |
| Authorized Official Name and Position | Arun Kumar Kantamneni (PSYCHIATRIST) |
| Authorized Official Contact | 7708818495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arun K Kantamneni Md, Inc. Po Box 2287 Duluth GA 30096-0040 Ph: () - | Arun K Kantamneni Md, Inc. 20 Herrell Rd Villa Rica GA 30180-5527 Ph: (770) 881-8495 |
| NPI Number | 1922491695 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 03/05/2015 |
| Medicare PECOS PAC ID | 7315268539 |
|---|---|
| Medicare Enrollment ID | O20150530000122 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922491695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 70171 (Georgia) | Primary |
| Provider Name | Amber N Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073862751 PECOS PAC ID: 6507018389 Enrollment ID: I20121129000456 |
| Provider Name | Arun K Kantamneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962659391 PECOS PAC ID: 3971739301 Enrollment ID: I20131113001467 |
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