Healthcare Provider Details

I. General information

NPI: 1477520013
Provider Name (Legal Business Name): SHAHNAZ BARI, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 W WHEELER PKWY
AUGUSTA GA
30909-1870
US

IV. Provider business mailing address

4102 SHADY OAKS DR
MARTINEZ GA
30907-7909
US

V. Phone/Fax

Practice location:
  • Phone: 706-863-3135
  • Fax:
Mailing address:
  • Phone: 706-731-2628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number033521
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number033521
License Number StateGA

VIII. Authorized Official

Name: WENDI K SNOOK
Title or Position: INS BILLING MGR
Credential:
Phone: 706-731-2628