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General NPI Number Information
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NPI Number | 1639477474
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Entity Type | Individual
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Provider Name | GAURAV SHEKHAWAT PHARMACIST
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Gender | Male
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 3055 WASHINGTON RD
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City | EAST POINT
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State | GA
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Zip | 30344-4565
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Country | US
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Telephone | 404-767-8789
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Fax |
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Provider Business Mailing Address
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Address Line | 1117 ADAMS LAKE BLVD SE
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City | ATLANTA
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State | GA
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Zip | 30339-3385
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Country | US
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Telephone | 862-812-4666
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH025134
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License Number State | GA
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