Organization
MILESTONE WELLNESS MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MOJGAN SHAHMAR (OWNER)
(404) 862-0372
Entity
Organization
Contact information
Practice address
8470 HOLCOMB BRIDGE RD, 140, ALPHARETTA, GA 30022-1854
(678) 461-9337
(678) 461-9338
Mailing address
8470 HOLCOMB BRIDGE RD, 140, ALPHARETTA, GA 30022-1854
(678) 461-9337
(678) 461-9338
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
032720
GA
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
061005
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144255399
HEALTHCARE PROVIDER
FM
01
—
1447494885
HEALTHCARE PROVIDER
GA
Enumeration date
09/04/2015
Last updated
09/04/2015
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