Individual
DR. MOIRA BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-5437
Mailing address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-5437
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
96593
GA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/03/2017
Last updated
08/14/2023
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