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Organization

PERSONAL FAMILY CARE, P.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANJAY K SHUKLA M.D. (PRESIDENT)
(706) 517-0533
Entity
Organization

Contact information

Practice address
106 HOSPITAL DR, SUITE 5, CHATSWORTH, GA 30705-2070
(706) 517-0533
(706) 517-3032
Mailing address
106 HOSPITAL DR, SUITE 5, CHATSWORTH, GA 30705-2070
(706) 517-0533
(706) 517-3032

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039940
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
039940
MEDICAL LICENSE
GA
Enumeration date
03/12/2007
Last updated
08/22/2020
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