Healthcare Provider Details

I. General information

NPI: 1275488769
Provider Name (Legal Business Name): RAHI AMITBHAI SHAH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DOWNWOOD CIR NW STE 410
ATLANTA GA
30327-1624
US

IV. Provider business mailing address

2319 NORBURY CV SE
SMYRNA GA
30080-5206
US

V. Phone/Fax

Practice location:
  • Phone: 678-646-8666
  • Fax:
Mailing address:
  • Phone: 678-646-8666
  • Fax: 678-646-8666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: