Individual
MR. AZHAR S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1979 LAKESIDE PKWY, STE. 250, TUCKER, GA 30084-5935
(678) 837-1252
(770) 908-2203
Mailing address
1979 LAKESIDE PKWY, STE. 250, TUCKER, GA 30084-5935
(678) 837-1252
(770) 908-2203
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2007028770
MO
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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