Individual
KENNETH TIMOTHY SHIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1281
(404) 712-2000
Mailing address
106 DOVER LN, OAK RIDGE, TN 37830-8793
(865) 242-1173
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
102752
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2020
Last updated
02/11/2025
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