Provider Demographics
NPI:1053339168
Name:MUNNA, RANA K (MD)
Entity type:Individual
Prefix:DR
First Name:RANA
Middle Name:K
Last Name:MUNNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PRESTON CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-5769
Mailing Address - Country:US
Mailing Address - Phone:478-238-0771
Mailing Address - Fax:478-238-6688
Practice Address - Street 1:107 PRESTON CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:478-238-0771
Practice Address - Fax:478-238-6688
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052466207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I07592Medicare UPIN
GA11SCCXKMedicare ID - Type Unspecified