Individual
SHIRAJ PANJWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
677 CHURCH ST NE, WELLSTAR KENNESTONE REGIONAL MEDICAL CTR. GME DEPT, MARIETTA, GA 30060-1101
(770) 793-5186
Mailing address
677 CHURCH ST NE, WELLSTAR KENNESTONE REGIONAL MEDICAL CTR. GME DEPT, MARIETTA, GA 30060-1101
(770) 793-5186
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
80445
GA
208M00000X
Hospitalist Physician
Primary
80445
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2016
Last updated
10/02/2019
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