Basic Information
| Provider Information | |||||||||
| NPI: | 1023347010 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | MOTLHATLHEDI | ||||||||
| FirstName: | ESTHER | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3495 PIEDMONT ROAD, NE | ||||||||
| Address2: | NINE PIEDMONT CENTER | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 305051736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043650966 | ||||||||
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| Practice Location | |||||||||
| Address1: | 750 TOWN PARK LANE | ||||||||
| Address2: | PAISER PERMANENTE TOWN PARK MEDICAL OFFICE-DEPT OF AMBU | ||||||||
| City: | KENNESAW | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9083373212 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2009 | ||||||||
| LastUpdateDate: | 01/30/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 25MA08695200 | NJ | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 63883 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.