Mitra Mofid, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

38362 Issued in KY

Practice address

2550 Windy Hill Road SE
Suite 103
Marietta, GA 30067-8607

Phone

(770) 952-0050

Fax

(770) 381-6451

NPI assigned

Oct 21, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wesley S Wilborn MD PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1750554978
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1669462610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 CHATTAHOOCHEE SUMMIT DR SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393253",
            "telephone_number": "714-328-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 WINDY HILL ROAD SE",
            "address_2": "SUITE 103",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678607",
            "telephone_number": "770-952-0050",
            "fax_number": "770-381-6451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFID",
        "first_name": "MITRA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "GA",
            "license": "051166",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "CA",
            "license": "A62702",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "KY",
            "license": "38362",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "051166",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A62702",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "KY",
            "license": "38362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.