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Organization
GWINNETT CLINIC LTD
Active
Organization
GWINNETT CLINIC LTD
Active
Other names
GWINNETT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DEEP SHAH MD, MSC (AUTHORIZED OFFICIAL)
(770) 995-3300
Entity
Organization
Contact information
Practice address
5330 NORTHWATER WAY, DULUTH, GA 30097-2485
(770) 840-8581
(770) 840-0641
Mailing address
10600 MEDLOCK BRIDGE RD, DULUTH, GA 30097-8404
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
GA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
02/06/2007
Last updated
01/25/2023
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