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Individual

DR. RAKESH RASIKLAL SHAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4010 OAK FOREST CIRCLE, MARIETTA, GA 30062
(404) 697-5625
(888) 669-9073
Mailing address
4010 OAK FOREST CIR, MARIETTA, GA 30062-5253
(404) 697-5625
(888) 669-9073

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
36761
TN
207R00000X
Internal Medicine Physician
Primary
056220
GA
207R00000X
Internal Medicine Physician
MD2016-0649
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110234591
RAILROAD MEDICARE
TN
Enumeration date
08/15/2005
Last updated
11/19/2018
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