Individual
DR. SHASHI MADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
135 N OAK ST, JACKSON, GA 30233
(770) 775-7675
(770) 775-7817
Mailing address
135 N OAK ST, JACKSON, GA 30233
(770) 775-7675
(770) 775-7817
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
037279
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00568554B
—
GA
01
—
110245216
RAILROAD MEDICARE
—
Enumeration date
11/07/2006
Last updated
10/22/2010
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