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General NPI Number Information
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NPI Number | 1376884585
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Entity Type | Organization
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Legal Business Name | ADVANCED UROLOGY SURGERY CENTER
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Dates
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Enumeration Date | 03/13/2013
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 1557 JANMAR RD
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City | SNELLVILLE
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State | GA
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Zip | 30078-5686
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Country | US
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Telephone | 678-344-8900
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Fax | 678-666-5201
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Provider Business Mailing Address
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Address Line | 1551 JANMAR RD
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City | SNELLVILLE
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State | GA
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Zip | 30078-5606
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Country | US
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Telephone | 678-344-8900
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Fax | 678-666-5201
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Authorized Official
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Title or Position | CEO
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Name | MR. BEEMAL SHAH
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Credential |
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Telephone | 706-951-8657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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