Individual
SARAH HELEN SHANEWISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
658 N CHASE ST STE 201, ATHENS, GA 30601-1960
(706) 353-2990
(706) 353-2992
Mailing address
3320 OLD JEFFERSON RD BLDG 700, ATHENS, GA 30607-1465
(706) 353-2990
(706) 353-2992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1110409
GA
363A00000X
Physician Assistant
Primary
6795
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003134042H
—
GA
01
—
1110409
NCCPA
GA
Enumeration date
05/08/2013
Last updated
11/22/2022
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