Anand T Shantha, MD | |
119 N Park Trl, Stockbridge, GA 30281-7373 | |
(770) 389-3739 | |
(770) 389-6565 |
Full Name | Anand T Shantha |
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Gender | Male |
Speciality | Urology |
Location | 119 N Park Trl, Stockbridge, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1225047301 | NPI | - | NPPES |
340020189 | Other | GA | RAILROAD MEDICARE |
000972804A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 050677 (Georgia) | Primary |
Entity Name | Georgia Urology, Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245250646 PECOS PAC ID: 8921094376 Enrollment ID: O20040422000123 |
Entity Name | Urological Professional Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033521810 PECOS PAC ID: 9638391717 Enrollment ID: O20141104002579 |
Mailing Address | Practice Location Address |
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Anand T Shantha, MD 1930 Brannan Rd, Mcdonough, GA 30253-4310 Ph: (678) 284-4040 | Anand T Shantha, MD 119 N Park Trl, Stockbridge, GA 30281-7373 Ph: (770) 389-3739 |
Mauro Folgosa, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 290 Country Club Dr, Suite 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
James Van Eaton, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Jonathan Zurawin, Urology Medicare: Accepting Medicare Assignments Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Robert Scott Libby, MD Urology Medicare: Medicare Enrolled Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Varon Alexander Garcias, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 290 Country Club Dr, Suite 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Saneal Rajanahally, Urology Medicare: Accepting Medicare Assignments Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 |