Individual
SHANDAREDA CHANTAY CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MMSC
Contact information
Practice address
1100 JOHNSON FERRY RD STE 410, ATLANTA, GA 30342-1709
(404) 847-0664
(404) 250-1694
Mailing address
1100 JOHNSON FERRY RD STE 410, ATLANTA, GA 30342-1709
(404) 847-0664
(404) 250-1694
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004742
GA
Other
Enumeration date
09/30/2008
Last updated
08/26/2024
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