Provider Demographics
NPI:1699762526
Name:RANNO, NICHOLAS S (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:S
Last Name:RANNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3155 N POINT PKWY
Mailing Address - Street 2:ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-645-9181
Mailing Address - Fax:770-645-8455
Practice Address - Street 1:2550 WINDY HILL RD SE
Practice Address - Street 2:SUITE 302
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8665
Practice Address - Country:US
Practice Address - Phone:678-574-0943
Practice Address - Fax:678-574-0943
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2012-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA28452207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000331724GMedicaid
GA000331724EMedicaid
GA000331724FMedicaid
GA000331724JMedicaid
GA000331724CMedicaid
GA000331724IMedicaid
GA000331724HMedicaid
GA000331724LMedicaid
GA000331724JMedicaid
GA000331724HMedicaid
GAB98817Medicare UPIN
GA000331724IMedicaid
GA000331724GMedicaid