Individual
GINA SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(850) 284-5532
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(850) 284-5532
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1457883860
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
04/03/2017
Last updated
08/01/2017
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