Healthcare Provider Details

I. General information

NPI: 1336313006
Provider Name (Legal Business Name): SHAYNA A ROAF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHAYNA SMITH MD

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8601 DUNWOODY PL STE 565
ATLANTA GA
30350-2516
US

IV. Provider business mailing address

8601 DUNWOODY PL STE 565
SANDY SPRINGS GA
30350-2516
US

V. Phone/Fax

Practice location:
  • Phone: 678-344-1960
  • Fax:
Mailing address:
  • Phone: 678-344-1960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number066077
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number066077
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: