Individual
MIJIN RA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
777 HEMLOCK ST, MSC #165, MACON, GA 31201-2102
(478) 633-1634
(478) 633-1578
Mailing address
777 HEMLOCK ST, MSC #165, MACON, GA 31201-2102
(478) 633-1634
(478) 633-1578
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16347
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
03/21/2024
Last updated
06/17/2024
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