# SLEEP DISORDER CENTER @ GWINNETT CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GWINNETT CLINIC, LTD
- **Other names:** GWINNETT CLINIC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619242302
- **Legal business name:** GWINNETT CLINIC, LTD
- **Authorized official:** DR. JAYENDRAKUMAR J SHAH MD (PRESIDENT)
- **Authorized official phone:** (770) 995-3300

## Contact information

- **Practice address:** 2650 LAWRENCEVILLE SUWANEE RD, STE B, SUWANEE, GA 30024-2535
- **Practice address phone:** (678) 205-5000
- **Practice address fax:** (678) 240-2080
- **Mailing address:** 475 PHILIP BLVD, STE 100, LAWRENCEVILLE, GA 30046-8737
- **Mailing address phone:** (770) 995-3300
- **Mailing address fax:** (770) 995-3307

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | — | NULL | Yes |
| 173000000X | Legal Medicine | — | — | Yes |
| 261QS1200X | Sleep Disorder Diagnostic Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 03/14/2012
- **Last updated:** 07/12/2021