Dr Shalini Mala Shah, MD | |
900 Towne Lake Pkwy Ste 306, Woodstock, GA 30189-1604 | |
(770) 852-7720 | |
(770) 852-7721 |
Full Name | Dr Shalini Mala Shah |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 900 Towne Lake Pkwy Ste 306, Woodstock, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649409244 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 68556 (Georgia) | Primary |
Entity Name | Northside Primary Care Professional Services,llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922397553 PECOS PAC ID: 9638343924 Enrollment ID: O20111123000206 |
Mailing Address | Practice Location Address |
---|---|
Dr Shalini Mala Shah, MD 684 Sixes Rd, Suite 220, Holly Springs, GA 30115-8721 Ph: (678) 388-5485 | Dr Shalini Mala Shah, MD 900 Towne Lake Pkwy Ste 306, Woodstock, GA 30189-1604 Ph: (770) 852-7720 |
Dr. Romualda S Klicius, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2230 Towne Lake Pkwy, Building 300, Suite 100, Woodstock, GA 30189 Phone: 770-517-1900 Fax: 770-926-3215 | |
Jordana A Heaven, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2000 Professional Way, Ste 200, Woodstock, GA 30188 Phone: 770-517-0250 Fax: 770-517-0260 | |
Dr. Ferdinand Domenic Yates Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 2000 Professional Way, #200, Woodstock, GA 30188 Phone: 770-517-0250 Fax: 770-517-0260 | |
Whitney Lauren Fose, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1007 Weatherstone Pkwy Ste 210, Woodstock, GA 30188 Phone: 470-203-0006 | |
Dr. Mohamed Midani, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 145 N Medical Pkwy, Woodstock, GA 30189 Phone: 770-517-1900 | |
Thanhtam Thi Le, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2000 Professional Way Ste 200, Woodstock, GA 30188 Phone: 770-517-0250 | |
Dr. Timothy Christopher Lorenz, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 155 River Park Xing, Woodstock, GA 30188 Phone: 770-924-9858 Fax: 770-924-9946 |