Individual
MUTINHIMA ROTH MOYO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3100
Mailing address
55 WHITCHER ST NE STE 130, MARIETTA, GA 30060-1156
(770) 428-0462
(770) 427-8001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036139289
IL
208600000X
Surgery Physician
Primary
053004
GA
2086S0127X
Trauma Surgery Physician
036139289
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
748065683A
—
GA
Enumeration date
08/03/2006
Last updated
04/07/2026
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