Provider Demographics
NPI:1043318827
Name:KASER, SHAWN G (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:G
Last Name:KASER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:574-232-4888
Practice Address - Street 1:2400 MOUNT ZION PKWY
Practice Address - Street 2:KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2500
Practice Address - Country:US
Practice Address - Phone:574-232-5928
Practice Address - Fax:574-232-4888
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2022-01-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2003017255207R00000X
IN01054448A207RC0000X
GA066857207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200373960Medicaid
H60055Medicare UPIN
IN184220XMedicare PIN