Individual
DR. QUDRATULLAH MOJADIDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-6667
(904) 244-3658
Mailing address
PO BOX 44008, JACKSONVILLE, FL 32231-4008
(904) 244-6667
(904) 244-3658
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
0101233197
VA
207V00000X
Obstetrics & Gynecology Physician
Primary
ME118314
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143859A
—
GA
05
—
010625600
—
FL
Enumeration date
06/20/2007
Last updated
04/23/2014
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