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Organization
PEACHTREE HEALTH GROUP LLC
Active
Organization
PEACHTREE HEALTH GROUP LLC
Active
Other names
Kennesaw Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
SHISHIR GUPTA MD (MEMBER)
(229) 563-3738
Entity
Organization
Contact information
Practice address
6110 PINE MOUNTAIN RD NW STE 201, KENNESAW, GA 30152-3357
(229) 563-3738
Mailing address
6110 PINE MOUNTAIN RD NW STE 201, KENNESAW, GA 30152-3357
(229) 563-2094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/27/2026
Last updated
05/21/2026
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