Healthcare Provider Details

I. General information

NPI: 1427191782
Provider Name (Legal Business Name): ROSHAN SHRESTHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW 77 BUILDING 5TH FLOOR
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

PO BOX 102321
ATLANTA GA
30368-2321
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number056765
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2024041976
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: