MEDICARE: MARI MORI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207SG0201X	Clinical Genetics (M.D.) Physician	35-122728	OH
2	207SG0202X	Clinical Biochemical Genetics Physician	35-122728	OH
3	207SG0207X	Medical Biochemical Genetics	35-122728	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	H669240	OTHER	OH	CGS-MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104010982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARI MORI MD

Provider Business Mailing Address
First Line	:	1365 CLIFTON RD NE STE 15001365
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-8570
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE STE A1500
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-0001
Country	:	US
Telephone Number	:	404-778-8570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	12/31/2025

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Directions to “ MARI MORI MD” Practice Location

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