Individual
DR. MANAN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-1501
(706) 724-6100
Mailing address
1499 WALTON WAY STE 1400, AUGUSTA, GA 30901-2603
(706) 828-8401
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
07909
GA
2084A2900X
Neurocritical Care Physician
Primary
079019
GA
2084N0400X
Neurology Physician
079019
GA
Other
Enumeration date
11/07/2012
Last updated
03/17/2018
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