Organization
360 UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BHAVIK B SHAH MD (OWNER)
(813) 842-5956
Entity
Organization
Contact information
Practice address
175 COUNTRY CLUB DR STE 300-E, STOCKBRIDGE, GA 30281-9054
(678) 941-4140
(678) 941-4139
Mailing address
175 COUNTRY CLUB DR STE 300-E, STOCKBRIDGE, GA 30281-9054
(678) 941-4140
(678) 941-4139
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
06/18/2024
Last updated
07/26/2024
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