Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Iviensan Fernandez Manalo, MD

Individual provider Dermatology Physician · NPI 1730542879

Iviensan Fernandez Manalo, MD is a Dermatology in Atlanta, Georgia. Graduated from Medical College of Georgia School of Medicine in 2016, 10 years ago. Practices with Southwest Skin Specialists LLC, a 51-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
10
Trained at
Medical College of Georgia School of Medicine
Licensed in
GA
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

875 Johnson Fy Rd NE Ste 300
Atlanta, GA 30342-1418
Phone: (404) 257-9933
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 85708 (GA)

Record details

NPI number1730542879
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 4, 2016
Last updated in NPPESJuly 20, 2020
Certification dateJuly 20, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolMEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Southwest Skin Specialists Llc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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