Provider Demographics
NPI:1689973513
Name:MOORE-STIGLER, HADIYA TORKWASE
Entity Type:Individual
Prefix:MRS
First Name:HADIYA
Middle Name:TORKWASE
Last Name:MOORE-STIGLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 GLEN VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-4278
Mailing Address - Country:US
Mailing Address - Phone:770-969-6334
Mailing Address - Fax:
Practice Address - Street 1:595 OLD NORCROSS RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3327
Practice Address - Country:US
Practice Address - Phone:770-995-6902
Practice Address - Fax:770-995-6959
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator