Organization
PEACHTREE HEALTH GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHISHIR GUPTA MD (MEMBER)
(229) 563-3738
Entity
Organization
Contact information
Practice address
6110 PINE MOUNTAIN RD NW STE 201, KENNESAW, GA 30152-3357
(229) 563-3738
Mailing address
6110 PINE MOUNTAIN RD NW STE 201, KENNESAW, GA 30152-3357
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/27/2026
Last updated
01/27/2026
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