Individual
DR. SIVAN MAZAL BEN-MOSHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1821 CLIFTON RD NE, ATLANTA, GA 30329-4021
(404) 728-6363
Mailing address
1821 CLIFTON RD NE, ATLANTA, GA 30329-4021
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
074696
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
074696
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2010
Last updated
10/27/2015
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