Individual
DR. TINA R SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060
(770) 422-1372
Mailing address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 422-1372
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036129928
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036129928
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
79413
GA
207RP1001X
Pulmonary Disease Physician
036129928
IL
390200000X
Student in an Organized Health Care Education/Training Program
MT192258
PA
Other
Enumeration date
06/20/2008
Last updated
09/30/2019
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