Individual
DR. KIRTI K SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
605 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4315
(770) 962-1231
(770) 513-2107
Mailing address
605 OLD NORCROSS RD, LAWRENCEVILLE, GA 30045-4315
(770) 962-1231
(770) 513-2107
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
027248
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00303069C
—
GA
05
—
00303069H
—
GA
01
—
390002084
RAILROAD MEDICARE
—
Enumeration date
06/16/2005
Last updated
10/25/2007
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