Individual
DR. CHARLES CALVIN UPSHAW III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(404) 851-6323
(404) 303-3747
Mailing address
5605 GLENRIDGE DR STE 325, ATLANTA, GA 30342-1365
(678) 553-7783
(678) 553-7793
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
20951
MS
2085R0202X
Diagnostic Radiology Physician
Primary
70598
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
70598
GEORGIA COMPOSITE MEDICAL BOARD
GA
Enumeration date
07/21/2008
Last updated
05/06/2019
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