Individual
MOJGAN REDJAMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 410, AUSTELL, GA 30106-6810
(678) 741-2317
(678) 741-2301
Mailing address
1700 HOSPITAL SOUTH DR, SUITE 410, AUSTELL, GA 30106-6810
(678) 741-2317
(678) 741-2301
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN160834NP
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I508336
MEDICARE PTAN 202I508336
GA
05
—
847967037A
—
GA
Enumeration date
04/02/2009
Last updated
10/22/2013
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