| Kiritkumar J. Shah, M.d.,pc | |
|
6360 Mableton Pkwy Sw Mableton GA 30126-5210 | |
| (770) 948-8600 | |
| (770) 944-7900 |
| Full Name | Kiritkumar J. Shah, M.d.,pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6360 Mableton Pkwy Sw, Mableton, Georgia |
| Authorized Official Name and Position | Kiritkumar Jivanlal Shah (PRESIDENT) |
| Authorized Official Contact | 7709488600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiritkumar J. Shah, M.d.,pc 6360 Mableton Pkwy Sw Mableton GA 30126-5210 Ph: (770) 948-8600 | Kiritkumar J. Shah, M.d.,pc 6360 Mableton Pkwy Sw Mableton GA 30126-5210 Ph: (770) 948-8600 |
| NPI Number | 1114207727 |
|---|---|
| Provider Enumeration Date | 08/26/2011 |
| Last Update Date | 08/26/2011 |
| Medicare PECOS PAC ID | 7810167806 |
|---|---|
| Medicare Enrollment ID | O20110830000748 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114207727 | NPI | - | NPPES |
| 00246287A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Kiritkumar Javanlal Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306912779 PECOS PAC ID: 4880580570 Enrollment ID: I20040227000754 |
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