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General NPI Number Information
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NPI Number | 1326218686
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Entity Type | Individual
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Provider Name | SHAILESH GANDHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1814 LAKEFIELD CT SE STE A
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City | CONYERS
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State | GA
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Zip | 30013-1776
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Country | US
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Telephone | 770-277-7195
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Fax | 888-747-9242
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Provider Business Mailing Address
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Address Line | 6555 SUGARLOAF PKWY # 258-307
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City | DULUTH
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State | GA
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Zip | 30097-4930
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Country | US
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Telephone | 770-277-7195
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Fax | 888-747-9242
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | C53284
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 034139
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | C53284
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License Number State | CA
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