Organization
DOUGLAS MEDICAL GROUP
Active
Other names
Shroff and Desai M D , P C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GIRISH I SHROFF MD (PRESIDENT)
(770) 949-0555
Entity
Organization
Contact information
Practice address
6025 PROFESSIONAL PKWY, SUITE 200, DOUGLASVILLE, GA 30134-5609
(770) 949-0555
(770) 949-4424
Mailing address
6025 PROFESSIONAL PKWY, SUITE 200, DOUGLASVILLE, GA 30134-5609
(770) 949-0555
(770) 949-4424
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
019103
GA
207R00000X
Internal Medicine Physician
027530
GA
207R00000X
Internal Medicine Physician
061515
GA
363L00000X
Nurse Practitioner
RN167533
GA
363LF0000X
Family Nurse Practitioner
RN095208
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000137827B
—
GA
05
—
002528159A
—
GA
05
—
00305302B
—
GA
05
—
452595412D
—
GA
Enumeration date
04/12/2007
Last updated
07/08/2010
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