Healthcare Provider Details

I. General information

NPI: 1831020379
Provider Name (Legal Business Name): SHAMORA BARNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

868 PARK PL NE
CONYERS GA
30012-4740
US

IV. Provider business mailing address

868 PARK PL NE
CONYERS GA
30012-4740
US

V. Phone/Fax

Practice location:
  • Phone: 678-347-3932
  • Fax:
Mailing address:
  • Phone: 678-347-3932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: