Organization
SLEEP DISORDER CENTER @ GWINNETT CLINIC
Active
Parent organization
GWINNETT CLINIC, LTD
Other names
GWINNETT CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GWINNETT CLINIC, LTD
Authorized official
DR. JAYENDRAKUMAR J SHAH MD (PRESIDENT)
(770) 995-3300
Entity
Organization
Contact information
Practice address
2650 LAWRENCEVILLE SUWANEE RD, STE B, SUWANEE, GA 30024-2535
(678) 205-5000
(678) 240-2080
Mailing address
475 PHILIP BLVD, STE 100, LAWRENCEVILLE, GA 30046-8737
(770) 995-3300
(770) 995-3307
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
—
—
Other
Enumeration date
03/14/2012
Last updated
07/12/2021
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