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General NPI Number Information
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NPI Number | 1821895632
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Entity Type | Organization
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Legal Business Name | ADVANCED UROLOGY INSTITUTE OF GEORGIA, PC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 5315 FLYNN CROSSING DRIVE
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City | ALPHARETTA
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State | GA
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Zip | 30005-1796
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Country | US
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Telephone | 678-344-8900
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Fax |
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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 | 470-579-5600
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Fax | 678-691-0506
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Authorized Official
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Title or Position | CEO
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Name | 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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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