Provider Demographics
NPI:1740621788
Name:DANAPAL, MAGENDRAN (MD)
Entity type:Individual
Prefix:
First Name:MAGENDRAN
Middle Name:
Last Name:DANAPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-2825
Mailing Address - Country:US
Mailing Address - Phone:478-743-9762
Mailing Address - Fax:478-743-9465
Practice Address - Street 1:575 1ST ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2825
Practice Address - Country:US
Practice Address - Phone:478-743-9762
Practice Address - Fax:478-743-9465
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-06
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY529512086S0129X
GA1029502086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery