Organization
MTN HEALTHCARE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CESAR AUGUSTO MAZZOTTA (DIRECTOR)
(770) 817-4117
Entity
Organization
Contact information
Practice address
1117 PERIMETER CTR W, SUITE N404, ATLANTA, GA 30338-5451
(770) 817-4117
(770) 817-4105
Mailing address
1117 PERIMETER CTR W, SUITE N404, ATLANTA, GA 30338-5451
(770) 817-4117
(770) 817-4105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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