Provider Demographics
NPI:1003076001
Name:SAHA, SHONALI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHONALI
Middle Name:
Last Name:SAHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 HIGHLANDS PKWY SE
Mailing Address - Street 2:STE 400
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-5166
Mailing Address - Country:US
Mailing Address - Phone:678-388-0946
Mailing Address - Fax:844-452-7877
Practice Address - Street 1:3200 HIGHLANDS PKWY SE
Practice Address - Street 2:STE 400
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-5166
Practice Address - Country:US
Practice Address - Phone:678-388-0946
Practice Address - Fax:844-452-7877
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA71280207RA0401X, 207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine