Provider Demographics
NPI:1184416745
Name:KAMANN, MARAH
Entity type:Individual
Prefix:
First Name:MARAH
Middle Name:
Last Name:KAMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 PRATT DR SE UNIT 1306
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-2184
Mailing Address - Country:US
Mailing Address - Phone:678-382-5363
Mailing Address - Fax:
Practice Address - Street 1:114 W TRINITY PL STE 16
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3392
Practice Address - Country:US
Practice Address - Phone:404-458-7467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10014247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty