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Organization

ELITE SURGICAL PC

Active
Other names
Baheeg L Shadeed MD
Organization subpart
No

Provider details

NPI number
Authorized official
BAHEEG LAWRENCE SHADEED M.D. (OWNER)
(770) 438-9191
Entity
Organization

Contact information

Practice address
3969 S COBB DR SE STE 202, SMYRNA, GA 30080-6317
(770) 438-9191
(770) 438-9272
Mailing address
3969 S COBB DR SE STE 202, SMYRNA, GA 30080-6317
(770) 438-9191
(770) 438-9272

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
024628
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000261665B
GA
Enumeration date
11/18/2013
Last updated
01/15/2014
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