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Individual

JANE C SHARE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1001 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1605
(404) 785-2162
Mailing address
PO BOX 1205, INDIANAPOLIS, IN 46206-1205
(866) 364-5679
(866) 388-2925

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
054280
GA
2085R0202X
Diagnostic Radiology Physician
054280
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
634160561
GA
Enumeration date
02/13/2006
Last updated
01/13/2017
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