Search › Georgia › 363A00000X
Reagan Marienga, PA
NPI 1417583709 · on the registry since 2020
Practice
- Address
- 1670 Clairmont Rd
Decatur, GA 30033 - Phone
- (404) 321-6111
- Organisation at this address
- Dva Atlanta
Atlanta Vamc
Atlanta Vamc
Atlanta Vamc
Atlanta VamcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 1,025
Additional practice sites
- 2728 Sunset Blvd Ste 400, West Columbia, SC
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- GA, SC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-03-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia