Individual
THERESA ELISE SHIREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(404) 727-5660
Mailing address
653 PARK VILLAGE DR NE, ATLANTA, GA 30306-4451
(319) 210-6999
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
94057
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/13/2017
Last updated
03/27/2023
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