Individual
NELLY MIZRAHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4855 RIVER GREEN PKWY, SUITE 700, DULUTH, GA 30096-8336
(770) 622-0880
(770) 622-9875
Mailing address
4855 RIVER GREEN PKWY, SUITE 700, DULUTH, GA 30096-8336
(770) 622-0880
(770) 622-9875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
058545
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058545
GA LICENSE
GA
05
—
170546490A
—
GA
Enumeration date
09/26/2006
Last updated
12/03/2010
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