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Individual

MS. HALEH SHAFA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER, DULUTH, GA 30096-4506
(404) 289-8777
(404) 289-9949
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(404) 378-2681

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT002259
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
141200948A
GA
Enumeration date
03/01/2007
Last updated
01/07/2022
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