Provider Demographics
NPI:1831916493
Name:MOJICA, MARIA H (INTERN STUDENT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:H
Last Name:MOJICA
Suffix:
Gender:F
Credentials:INTERN STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4210 COLUMBIA RD STE 11B
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-0443
Mailing Address - Country:US
Mailing Address - Phone:706-364-6576
Mailing Address - Fax:
Practice Address - Street 1:4210 COLUMBIA RD STE 11B
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-0443
Practice Address - Country:US
Practice Address - Phone:706-364-6576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program