Provider Demographics
NPI:1629154554
Name:USADI, MOSHE M (MD)
Entity Type:Individual
Prefix:DR
First Name:MOSHE
Middle Name:M
Last Name:USADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1545 RAINIER FALLS DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4105
Mailing Address - Country:US
Mailing Address - Phone:770-750-5101
Mailing Address - Fax:864-448-1760
Practice Address - Street 1:1545 RAINIER FALLS DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4105
Practice Address - Country:US
Practice Address - Phone:770-750-5101
Practice Address - Fax:864-448-1760
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2021-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC200000645207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1423JOtherBCBS
NC5909033Medicaid
NC1423JOtherBCBS
NC2851728BMedicare PIN