MEDICARE: MENYON SHAMI MCBRIDE-COLVARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1659053676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MENYON SHAMI MCBRIDE-COLVARD

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3885 PRINCETON LAKES WAY SW STE 408
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-5599
Country	:	US
Telephone Number	:	404-344-2823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	07/16/2025

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