Individual
BIMAL R SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 ST. SEBASTIAN WAY, SUITE 2A, AUGUSTA, GA 30901
(706) 722-1249
(706) 722-1947
Mailing address
820 ST. SEBASTIAN WAY, SUITE 2A, AUGUSTA, GA 30901
(706) 722-1249
(706) 722-1947
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
037682
GA
174400000X
Specialist
17759
SC
207R00000X
Internal Medicine Physician
Primary
037682
GA
207RC0000X
Cardiovascular Disease Physician
037682
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00571128B
—
GA
05
—
G37682
—
SC
Enumeration date
09/21/2006
Last updated
03/03/2020
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