MEDICARE: JEFF SHIOVITZ

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	251E00000X	Home Health Agency	044-R-0095	GA

General Provider Information

NPI Number	:	1992258313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFF SHIOVITZ

Provider Business Mailing Address
First Line	:	4511 CHAMBLEE DUNWOODY ROAD
Second Line	:	SUITE A4
City	:	ATLANTA
State	:	GA
Zip	:	30338
Country	:	US
Telephone Number	:	770-392-8952
Fax Number	:	678-691-5341

Provider Business Practice Location Address
First Line	:	4511 CHAMBLEE DUNWOODY RD
Second Line	:	SUITE A4
City	:	ATLANTA
State	:	GA
Zip	:	30338-6243
Country	:	US
Telephone Number	:	770-392-8952
Fax Number	:	678-691-5341

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

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	08/02/2016

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Directions to “ JEFF SHIOVITZ ” Practice Location

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