Healthcare Provider Details

I. General information

NPI: 1518216225
Provider Name (Legal Business Name): HANA ABDULLAHI SHASH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW STE 2065
ATLANTA GA
30309-1705
US

IV. Provider business mailing address

6225 CROFTON DR.
ALPHARETTA GA
30005
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-2800
  • Fax:
Mailing address:
  • Phone: 770-309-9590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6582
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: