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General NPI Number Information
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NPI Number | 1881570992
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Entity Type | Organization
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Legal Business Name | HEART OF RAPHA LLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 125 EAGLES WALK STE 150
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7207
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Country | US
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Telephone | 470-507-0029
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Fax | 470-507-0030
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Provider Business Mailing Address
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Address Line | 2831 LAKE JODECO RD
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City | JONESBORO
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State | GA
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Zip | 30236-5335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNE AURELIE NGO TEDGA MOCHE
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Credential | MD
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Telephone | 470-507-0029
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number |
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License Number State |
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