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Individual

ISHA DAVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-5076
(706) 475-6676
Mailing address
PO BOX 117265, ATLANTA, GA 30368-7265

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016019921
MO
207R00000X
Internal Medicine Physician
86590
GA
208000000X
Pediatrics Physician
2016019921
MO
208M00000X
Hospitalist Physician
Primary
86590
GA

Other

Enumeration date
07/01/2016
Last updated
09/10/2020
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