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Individual

DR. SHILPI DAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-7000
(706) 475-7684
Mailing address
1500 OGLETHORPE AVE, SUITE 600F, ATHENS, GA 30606-2179
(706) 475-4639
(706) 475-4636

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
060447
GA
208000000X
Pediatrics Physician
Primary
060447
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01YP05102NH02
ANTHEM BC/BS
NH
01
020350051
FEDERAL TAX ID
01
11867
STATE LICENSE #
NH
01
2184240001
CIGNA HEALTHCARE
NH
05
30204719
NH
01
5830418
AETNA GROUP
01
P00100688
RAILROAD MEDICARE
Enumeration date
08/10/2005
Last updated
03/07/2023
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