Healthcare Provider Details

I. General information

NPI: 1467515734
Provider Name (Legal Business Name): RAZLUDIN Y MOOSAJEE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF AFTER HOURS 3495 PIEDMONT ROAD NE I
ATLANTA GA
30305
US

IV. Provider business mailing address

3495 PIEDMONT ROAD NE NINE PIEDMONT CENTER
ATLANTA GA
30305-9775
US

V. Phone/Fax

Practice location:
  • Phone: 404-364-7000
  • Fax:
Mailing address:
  • Phone: 404-364-7000
  • Fax: 404-364-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number023483
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: