Individual
RAKENDU PRAKASH SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
148 BILL CARRUTH PKWY STE LL30, HIRAM, GA 30141-3768
(770) 505-3855
(770) 443-6654
Mailing address
148 BILL CARRUTH PARKWAY SUITE LL30, HIRAM, GA 30141
(470) 644-8140
(770) 443-6654
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
85977
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
06/25/2013
Last updated
10/02/2020
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