Individual
SANJAY K SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3130 MATHIS AIRPORT PKWY, STE. 305, SUWANEE, GA 30024-9131
(770) 886-7711
(770) 886-7698
Mailing address
PO BOX 769609, ROSWELL, GA 30076-8224
(770) 886-7711
(770) 886-7698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
039940
GA
Other
Enumeration date
02/03/2006
Last updated
08/31/2012
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