Provider Demographics
NPI:1841741493
Name:MODY, BELA G (APN)
Entity type:Individual
Prefix:
First Name:BELA
Middle Name:G
Last Name:MODY
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 SLOAN RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5309
Mailing Address - Country:US
Mailing Address - Phone:708-275-1141
Mailing Address - Fax:
Practice Address - Street 1:3350 RIVERWOOD PKWY SE STE 1850
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3300
Practice Address - Country:US
Practice Address - Phone:404-392-9890
Practice Address - Fax:404-467-2489
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN256438163W00000X, 363LF0000X
FLAPRN11015838363LF0000X
NJ26NJ00678300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse