Provider Demographics
NPI:1942454871
Name:MOREJON, ALBERTO (DO)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:MOREJON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 PERIMETER CTR N
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-3402
Mailing Address - Country:US
Mailing Address - Phone:404-596-5599
Mailing Address - Fax:404-596-5599
Practice Address - Street 1:303 PERIMETER CTR N
Practice Address - Street 2:SUITE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-3402
Practice Address - Country:US
Practice Address - Phone:404-596-5599
Practice Address - Fax:404-596-5599
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64609208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003111427AMedicaid
GAP01001711OtherRR MEDICARE
GA003111427AMedicaid
GA202I254165Medicare PIN