Organization
EASTSIDE ENDOCRINE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NALAND P. SHENOY MD (PRESIDENT)
(770) 979-7466
Entity
Organization
Contact information
Practice address
1600 MEDICAL WAY, SUITE200, SNELLVILLE, GA 30078
(770) 979-7466
(770) 979-7455
Mailing address
1600 MEDICAL WAY, SUITE 200, SNELLVILLE, GA 30078
(770) 979-7466
(770) 979-7455
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
053165
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP5151
MEDICARE GROUP
GA
Enumeration date
10/01/2007
Last updated
12/19/2011
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