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General NPI Number Information
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NPI Number | 1467298828
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Entity Type | Individual
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Provider Name | ERICA EUNSEO SHIN OD
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Gender | Female
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Dates
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Enumeration Date | 07/05/2024
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 50 MAIN STREET MARKET PL SE STE 100
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City | CARTERSVILLE
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State | GA
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Zip | 30121-3311
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Country | US
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Telephone | 770-382-6379
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Fax |
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Provider Business Mailing Address
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Address Line | 5755 GLENRIDGE DR UNIT 162
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City | ATLANTA
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State | GA
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Zip | 30328-5552
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Country | US
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Telephone | 404-989-5685
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT003654
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11104T
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License Number State | TX
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