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General NPI Number Information
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NPI Number | 1154716405
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Entity Type | Individual
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Provider Name | PRIYA GULATI SHAH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2015
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 204 DAWSON VILLAGE WAY S
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City | DAWSONVILLE
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State | GA
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Zip | 30534-5629
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Country | US
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Telephone | 770-268-4360
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Fax | 470-251-6066
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Provider Business Mailing Address
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Address Line | 3333 RIVERWOOD PKWY SE STE 250
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City | ATLANTA
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State | GA
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Zip | 30339-3304
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Country | US
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Telephone | 770-914-0116
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Fax | 770-955-4278
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 80374
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License Number State | GA
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