Individual
SIVA B MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6507 PROFESSIONAL PL, RIVERDALE, GA 30274-4941
(770) 991-2100
(770) 991-1385
Mailing address
6507 PROFESSIONAL PL, RIVERDALE, GA 30274-4941
(770) 991-2100
(770) 991-1385
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
200300851
NC
207RC0000X
Cardiovascular Disease Physician
060411
GA
207RI0011X
Interventional Cardiology Physician
Primary
060411
GA
Other
Enumeration date
09/01/2006
Last updated
02/16/2023
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