Dev Mangalat (NPI# 1609040401, PAC ID# 7911022868) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is VASCULAR SURGERY.
| Nation Provider ID (NPI) | 1609040401 |
| PAC ID by PECOS | 7911022868 |
| Professional Enrollment ID | I20100915000579 |
| Full Name | Dev Mangalat |
| Organization Legal Name | THE LONGSTREET CLINIC, PC |
| Address |
500 Medical Ctr Blvd Suite 310 Lawrenceville GA 30046-3332 |
| Phone Number | 6782074000 |
| Gender | M |
| Graduation Year | 2003 |
| Primary Specialty | VASCULAR SURGERY |
| Secondary Specialties | GENERAL SURGERY |
| Group Practice PAC ID | 2668465733 |
| Number of Group Practice Members | 114 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110029 | NORTHEAST GEORGIA MEDICAL CENTER, INC |
| 110087 | GWINNETT MEDICAL CENTER |
| 110005 | NORTHSIDE HOSPITAL FORSYTH |
| Address | Phone | Organization |
|---|---|---|
| 1400 River Pl, Braselton, GA 30517-5600 | 7705362323 | THE LONGSTREET CLINIC, PC |
| 725 Jesse Jewell Pkwy, Suite 150, Gainesvilel, GA 30501-3834 | 7702975700 | THE LONGSTREET CLINIC, PC |
| 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 | 7707181122 | THE LONGSTREET CLINIC, PC |
| 725 Jesse Jewell Sepkwy, Suite 100, Gainesville, GA 30501-3836 | 7705353611 | THE LONGSTREET CLINIC, PC |
| 500 Medical Ctr Blvd, Suite 310, Lawrenceville, GA 30046-3332 | 6782074000 | THE LONGSTREET CLINIC, PC |
| 631 Professional Dr, Suite 240, Lawrenceville, GA 30046-3397 | 6782074000 | THE LONGSTREET CLINIC, PC |
| Organization Legal Name | THE LONGSTREET CLINIC, PC |
| Physicians | 137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Evgenia Korytnaya | Endocrinology | The Longstreet Clinic, PC | 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 |
| Hugh Colby Cornelson | Nurse Practitioner | The Longstreet Clinic, PC | 655 Jesse Jewell Pkwy Se, Suite A, Gainesville, GA 30501-3854 |
| Erica Mcdaniel Abney | Physician Assistant | The Longstreet Clinic, PC | 725 Jesse Jewell Pkwy, Suite 150, Gainesvilel, GA 30501-3834 |
| Karl D Schultz | Neurosurgery | The Longstreet Clinic, PC | 1240 Jesse Jewell Sepkwy, Suite 300, Gainesville, GA 30501-3861 |
| Andrew B Reisman | Family Medicine | The Longstreet Clinic, PC | 4222 Fairbanks Dr, Oakwood, GA 30566-2811 |
| David A Bray | Internal Medicine | The Longstreet Clinic, PC | 541 Historic Hwy 441-n, Demorest, GA 30535 |
| Mark D Clark | Nurse Practitioner | The Longstreet Clinic, PC | 725 Jesse Jewell Sepkwy, Suite 300, Gainesville, GA 30501-3846 |
| Eileen Dalmacio Javellana | Internal Medicine | The Longstreet Clinic, PC | 725 Jesse Jewell Pkwy, Suite 150, Gainesvilel, GA 30501-3834 |
| Brandi N Monroe | Physician Assistant | The Longstreet Clinic, PC | 725 Jesse Jewell Pkwy, Suite 150, Gainesvilel, GA 30501-3834 |
| Jeanette Susan Pirkle | Nurse Practitioner | The Longstreet Clinic, PC | 725 Jesse Jewell Pkwy, Suite 150, Gainesvilel, GA 30501-3834 |
| Street Address |
500 MEDICAL CTR BLVD SUITE 310 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip | 30046-3332 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amanda W Basford | Nephrology | Kidney Specialists of North Houston | 500 Medical Ctr Blvd, Suite 235, Conroe, TX 77304-2800 |
| Joseph F Pohl | Gynecological Oncology | 500 Medical Ctr Blvd, Suite 365, Lawrenceville, GA 30045-8708 | |
| Khanh N Le | Gastroenterology | Texas Digestive Disease Consultants Pllc | 500 Medical Ctr Blvd, Suite 240, Conroe, TX 77304-2800 |
| James Westmoreland | Orthopedic Surgery | 500 Medical Ctr Blvd, Suite 218, Conroe, TX 77304-2833 | |
| Mirza N Baig | Neurosurgery | Neuro Care Partners Pllc | 500 Medical Ctr Blvd, Suite 220, Conroe, TX 77304-2800 |
| Adam I Frome | Nephrology | Kidney Specialists of North Houston | 500 Medical Ctr Blvd, Suite 235, Conroe, TX 77304-2800 |
| James R Freeman | Obstetrics/gynecology | 500 Medical Ctr Blvd, Suite 300, Lawrenceville, GA 30046-3332 | |
| Imran Fayaz | Neurosurgery | 500 Medical Ctr Blvd, Suite 222, Conroe, TX 77304-2800 | |
| Wajid A Mirza | Internal Medicine | 500 Medical Ctr Blvd, Webster, TX 77598-4220 | |
| Charles P Read | Obstetrics/gynecology | Pediatrix Medical Group of Ga, P.C. | 500 Medical Ctr Blvd, Suite 210, Lawrenceville, GA 30045-3380 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Chundra Brooks | Nurse Practitioner | Aga Professional Services LLC | 301 Phillip Blvd, Suite A, Lawrenceville, GA 30046 |
| Gail S Hammond | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Kenneth L Knight | Clinical Social Worker | 295 S Culver St, Suite A, Lawrenceville, GA 30046-3239 | |
| Robert W Stevens | Chiropractic | 368 W Pike St, Suite 202, Lawrenceville, GA 30046-3240 | |
| Mehdi Kazemzadeh | Optometry | 575 Professional Dr, Suite 100, Lawrenceville, GA 30046-3300 | |
| Raymond L Stovall | Internal Medicine | 575 Professional Dr, Suite 310, Lawrenceville, GA 30046-3300 | |
| Jeffrey D Zwiren | Plastic and Reconstructive Surgery | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Kelly H Scoggins | Nurse Practitioner | Gwinnett Physician Group,llc | 100 Medical Ctr Blvd, Suite 165, Lawrenceville, GA 30046-3301 |
| Pamela A Boyd | Nurse Practitioner | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| William G Tanner Jr. | Gastroenterology | Gastroenterology Specialists of Gwinnett, P.C. | 721 Wellness Way, Suite 100, Lawrenceville, GA 30046-3304 |
| Find all physicians in zip 30046 | |||
| City | LAWRENCEVILLE |
| Zip Code | 30046 |
| Specialty | VASCULAR SURGERY |
| City + Specialty | LAWRENCEVILLE + VASCULAR SURGERY |
Please comment or provide details below to improve the information on Dev Mangalat.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.