Provider Demographics
NPI:1306811823
Name:MAJOCH, MARK (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:MAJOCH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3855 PLEASANT HILL RD
Mailing Address - Street 2:STE 100
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1407
Mailing Address - Country:US
Mailing Address - Phone:770-495-0155
Mailing Address - Fax:770-813-1298
Practice Address - Street 1:3855 PLEASANT HILL RD
Practice Address - Street 2:STE 100
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1407
Practice Address - Country:US
Practice Address - Phone:770-495-0155
Practice Address - Fax:770-813-1298
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-19
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA036651207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA036651OtherMED LIC NUMBER
GA036651OtherMED LIC NUMBER
GA036651OtherMED LIC NUMBER