MARJAN MOGHADDAM (NPI# 1457615247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457615247 |
| Entity Type | Individual |
| Full Name | MARJAN MOGHADDAM |
| Credential | D.O |
| Practice Address |
48 Main St Suite 3a Senoia GA 30276-1895 |
| Mailing Address |
10203 Merrick Dr Peachtree City GA 30269-6690 |
| Practice Telephone | 6787230400 |
| Mailing Telephone | 2485952328 |
| Enumeration Date | 2012-06-27 |
| Last Update Date | 2018-11-21 |
| NPI Deactivation Date | 10/22/2018 |
| NPI Reactivation Date | 2018-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 077644 | GA | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 5101019748 | MI | Allopathic & Osteopathic Physicians |
| Street Address |
48 MAIN ST SUITE 3A |
| City | SENOIA |
| State | GA |
| Zip Code | 30276-1895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962863431 | Kim Pogue | Social Worker | 48 Main St, Suite 3a, Senoia, GA 30276-1895 | 2016-03-11 |
| 1235517343 | Palmetto Health Council, Inc. | Clinic/Center | 48 Main St, Suite 3a, Senoia, GA 30276-1895 | 2015-05-08 |
| 1043356355 | Monica O Watts | Family Medicine | 48 Main St, Suite 3-a, Senoia, GA 30276-1895 | 2007-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962976563 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 10 Village West Dr. Ste A, Senoia, GA 30276 | 2019-01-16 |
| 1518406842 | Corey Ann Tolbert | Dietitian, Registered | 20 Charleston Dr, Senoia, GA 30276 | 2017-02-20 |
| 1639509920 | Priscilla Jane Thompson | Chore Provider | 229 Deep South Rd, Senoia, GA 30276 | 2013-11-22 |
| 1821331711 | Dana R. Chaffin | Family Medicine | 7285 Highway 16, Suite C, Senoia, GA 30276 | 2013-03-29 |
| 1396747077 | Christina R. Macaluso | Family Medicine | 42 Main Street, Suite 2a, Senoia, GA 30276 | 2005-08-12 |
| 1902236284 | Compassionate Hands Personal Care | Nursing Care | 229 Deep South Rd, Senoia, GA 30276 | 2013-11-22 |
| 1871640920 | Fred Richard Reynolds | Counselor | 252 Seavy Street, Senoia, GA 30276-0147 | 2007-01-04 |
| 1710270996 | Gregory C. Offor | Pharmacist | 120 Renwick Dr, Senoia, GA 30276-1361 | 2011-05-23 |
| 1013445162 | Emily Greene Schubert | Behavioral Analyst | 298 Seavy St, Senoia, GA 30276-1806 | 2017-06-01 |
| 1972830263 | Paraclete Christian Counseling and Educational Services | Community/Behavioral Health | 252 Seavy St, Senoia, GA 30276-1806 | 2009-11-09 |
| Find all providers in zip 30276 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821331711 | Dana R. Chaffin | Family Medicine | 7285 Highway 16, Suite C, Senoia, GA 30276 | 2013-03-29 |
| 1881861839 | Katherine Eleanor Wiegman | Family Medicine | 48 Main St Ste 3a, Senoia, GA 30276-1895 | 2008-05-09 |
| 1659321099 | Billy Eugene Greening | Family Medicine | 7285 Highway 16, Suite C, Senoia, GA 30276-3357 | 2006-05-10 |
| 1396747077 | Christina R. Macaluso | Family Medicine | 42 Main Street, Suite 2a, Senoia, GA 30276 | 2005-08-12 |
| 1013446111 | Deborah Mischelle Scott | Family Medicine | 7285 Highway 16 Ste C, Senoia, GA 30276-3348 | 2017-06-12 |
| 1043356355 | Monica O Watts | Family Medicine | 48 Main St, Suite 3-a, Senoia, GA 30276-1895 | 2007-01-30 |
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| 1841800836 | Ascend Medical Georgia PC | Family Medicine | One Alliance Center, 3500 Lenox Road Suite 1500, Atlanta, GA 30326 | 2020-08-04 |
| 1407464084 | Railyard Family Medicine LLC | Family Medicine | 416 Grayson Pkwy, Grayson, GA 30017-1220 | 2020-07-20 |
| 1851909535 | Newly Sought After International LLC | Family Medicine | 11815 Northfall Ln Ste 1001, Alpharetta, GA 30009-7973 | 2020-07-17 |
| 1992323398 | Careperks LLC | Family Medicine | 4936 Presidents Way, Tucker, GA 30084-3038 | 2020-07-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.