Individual
MOALLIM MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
116 RIDGE CREEK DR, CLARKSTON, GA 30021-2000
(678) 665-0570
Mailing address
116 RIDGE CREEK DR, CLARKSTON, GA 30021-2000
(678) 665-0570
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
RN323743
GA
374U00000X
Home Health Aide
Primary
PHCP013263
GA
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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