Individual
DR. INDRA C SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 OLD NORCROSS RD STE A, LAWRENCEVILLE, GA 30046-4311
(770) 963-2474
(770) 963-2476
Mailing address
601 OLD NORCROSS RD STE A, LAWRENCEVILLE, GA 30046-4311
(770) 963-2474
(770) 963-2476
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
023224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23224
MD LICENSE
GA
Enumeration date
03/13/2007
Last updated
02/16/2011
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