Organization
GWINNETT CLINIC LTD
Active
Other names
GWINNETT CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
DEEP SHAH MD, MSC (AUTHORIZED OFFICIAL)
(770) 995-3300
Entity
Organization
Contact information
Practice address
5330 NORTHWATER WAY, DULUTH, GA 30097-2485
(770) 840-8581
(770) 840-0641
Mailing address
10600 MEDLOCK BRIDGE RD, DULUTH, GA 30097-8404
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
—
GA
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2007
Last updated
01/25/2023
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