Mold Clinics of America

Primary specialty

Clinical & Laboratory Immunology (Internal Medicine) PhysicianTaxonomy code 207RI0001X

License

MD123445 Issued in GA

Legal business name

MOLD CLINICS OF AMERICA

Practice address

6063 Peachtree Pkwy
Suite 203 B
Norcross, GA 30092-3303

Phone

(770) 840-7121

Fax

(770) 209-9302

NPI assigned

May 9, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Leslie Hutchinson, MD

Title

Director

Phone

(770) 840-7121

Specialties & licenses 1

Addresses

Other names 1

• MoldTC Doing business as

Locations

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210291200000",
    "number": "1942477989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6063 PEACHTREE PKWY",
            "address_2": "SUITE 203 B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923303",
            "telephone_number": "770-840-7121",
            "fax_number": "770-209-9302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6063 PEACHTREE PKWY",
            "address_2": "SUITE 203 B",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923303",
            "telephone_number": "770-840-7121",
            "fax_number": "770-209-9302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLD CLINICS OF AMERICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2008-05-09",
        "status": "A",
        "authorized_official_last_name": "HUTCHINSON",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-840-7121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Clinical & Laboratory Immunology",
            "state": "GA",
            "license": "MD123445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MoldTC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Valerie Lynn Mius
• Mmsmsmm LLC
• Tannaz Modaresi, D.C
• Mofazzal Suraiya LLC
• Edward H Mohme, DMD
• Nene M Moma, O.D
• Kamela Momin, M.D.
• Marie Ange Mompoint, FNP
• Mercedes Eliza Moncada, CPNP-PC
• Edilberto Montenegro Sr.

• Internal Medicine Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.