Organization
SHUBHANG MAZUMDAR MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HELEN CHANG (BILLING PERSON)
(770) 952-2048
Entity
Organization
Contact information
Practice address
2550 WINDY HILL RD SE STE 309, MARIETTA, GA 30067-8655
(770) 951-1565
(770) 988-0563
Mailing address
2550 WINDY HILL RD SE STE 309, MARIETTA, GA 30067-8655
(770) 951-1565
(770) 988-0563
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19297
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00266791C
—
GA
01
—
DD5386
RAILROAD MEDICARE GROUP NUMBER
GA
01
—
GRP2975
MEDICARE GROUP NUMBER
GA
Enumeration date
01/24/2007
Last updated
10/27/2010
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