Individual
AHMED IJAZ SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 MARTIN LUTHER KING JR BLVD, MACON, GA 31201-3490
(478) 301-4111
(478) 301-5812
Mailing address
PO BOX 4947, MACON, GA 31208-4947
(478) 301-2362
(478) 301-2272
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
064736
GA
207RI0011X
Interventional Cardiology Physician
Primary
064736
GA
Other
Enumeration date
01/08/2007
Last updated
12/15/2021
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