MEDICARE: SHASHIKANT A DAYA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	GA037520	GA
2	207U00000X	Nuclear Medicine Physician	GA037520	GA
3	207UN0901X	Nuclear Cardiology Physician	GA037520	GA
4	207UN0902X	Nuclear Imaging & Therapy Physician	GA037520	GA
5	207UN0903X	In Vivo & In Vitro Nuclear Medicine Physician	GA037520	GA
6	261QR0200X	Radiology Clinic/Center	037520	GA
7	261QM1300X	Multi-Specialty Clinic/Center	037520	GA
8	2085N0904X	Nuclear Radiology Physician	037520	GA
9	207QA0505X	Adult Medicine Physician	037520	GA
10	207QG0300X	Geriatric Medicine (Family Medicine) Physician	037520	GA
11	2083X0100X	Occupational Medicine Physician	037520	GA
12	207Q00000X	Family Medicine Physician	037520	GA
13	207UN0901X	Nuclear Cardiology Physician	037520	GA
14	207UN0902X	Nuclear Imaging & Therapy Physician	037520	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	GRP7052	OTHER	GA	MEDICARE GROUP PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760512016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHASHIKANT A DAYA MD

Provider Business Mailing Address
First Line	:	3305 BOBBY BROWN PKWY
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-5012
Country	:	US
Telephone Number	:	404-806-8181
Fax Number	:	770-456-5469

Provider Business Practice Location Address
First Line	:	3305 BOBBY BROWN PKWY
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-5012
Country	:	US
Telephone Number	:	404-806-8181
Fax Number	:	770-456-5469

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	10/19/2014

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Directions to “ SHASHIKANT A DAYA MD” Practice Location

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