Individual
MR. NATHAN MORDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 HOSPITAL BLVD STE 340, ROSWELL, GA 30076-4977
(470) 956-4590
(678) 393-1969
Mailing address
2500 HOSPITAL BLVD STE 340, ROSWELL, GA 30076-4977
(470) 956-4590
(678) 393-1969
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
045895
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00800148A
—
GA
01
—
16BBBSP
MEDICARE ID/105 COLLIER ROAD SUITE 1010
GA
01
—
45895
GA. MED. LICENSE
GA
01
—
DA6300
MEDICARE RAILROAD PIN
GA
Enumeration date
05/02/2006
Last updated
07/12/2023
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