Individual
DR. SHIRISH AMRUTIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(516) 665-1883
(678) 493-5608
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD434851
PA
207RP1001X
Pulmonary Disease Physician
Primary
70034
GA
390200000X
Student in an Organized Health Care Education/Training Program
MT186542
PA
Other
Enumeration date
06/11/2008
Last updated
08/18/2021
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