Individual
DR. SHAUN S BATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(470) 732-4022
Mailing address
3950 AUSTELL RD, AUSTELL, GA 30106-1121
(470) 732-4022
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
076426
GA
207R00000X
Internal Medicine Physician
280428
NY
208M00000X
Hospitalist Physician
Primary
076426
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04267130
—
NY
Enumeration date
04/12/2012
Last updated
07/21/2022
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