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General NPI Number Information
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NPI Number | 1114419280
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Entity Type | Individual
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Provider Name | JANELLE A SHAH PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 135 N PARK PL STE 101
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7237
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Country | US
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Telephone | 770-892-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 135 N PARK PL STE 101
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-7237
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Country | US
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Telephone | 770-892-0300
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Fax | 470-878-1495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA60839895
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | C0007515
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License Number State | MD
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