Individual
EZRA MOZELLE ASH-MALACHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
905 STATE ST, CAYCE, SC 29033-4318
(803) 832-4383
Mailing address
PO BOX 740013, ATLANTA, GA 30374-0013
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29969
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
299698
—
SC
01
—
GP1883
MEDICAID GROUP
SC
01
—
GP2626
MEDICAID GROUP
SC
Enumeration date
08/22/2007
Last updated
04/07/2025
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