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NPI Code Detail

MEDICARE: FRENY SHAH M.D.

MEDICARE: FRENY SHAH M.D.
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
1207R00000XInternal Medicine Physician280129NY
2207R00000XInternal Medicine Physician88967GA

General Provider Information

NPI Number : 1942592787
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRENY SHAH M.D.
Provider Business Mailing Address
First Line : PO BOX 746087
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6087
Country : US
Telephone Number : 312-733-9730
Fax Number :
Provider Business Practice Location Address
First Line : 1825 ROCKBRIDGE RD STE 15B
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30087-3306
Country : US
Telephone Number : 470-444-3134
Fax Number : 470-276-4370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2011
Last Update Date : 08/26/2024

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