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General NPI Number Information
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NPI Number | 1114207727
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Entity Type | Organization
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Legal Business Name | KIRITKUMAR J. SHAH, M.D.,PC
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 6360 MABLETON PKWY SW
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City | MABLETON
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State | GA
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Zip | 30126-5210
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Country | US
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Telephone | 770-948-8600
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Fax | 770-944-7900
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Provider Business Mailing Address
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Address Line | 6360 MABLETON PKWY SW
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City | MABLETON
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State | GA
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Zip | 30126-5210
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Country | US
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Telephone | 770-948-8600
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Fax | 770-944-7900
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KIRITKUMAR JIVANLAL SHAH
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Credential | M.D.
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Telephone | 770-948-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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