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Individual

DR. PHILIP SHRAKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
311 PHILIP BLVD, LAWRENCEVILLE, GA 30045-8733
(770) 995-3000
(770) 995-1427
Mailing address
PO BOX 116470, ATLANTA, GA 30368-0001
(770) 682-2080
(678) 579-9398

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
046327
GA
2085R0001X
Radiation Oncology Physician
Primary
46327
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000809729D
GA
05
00809729A
GA
Enumeration date
12/01/2005
Last updated
10/01/2015
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