Provider Demographics
NPI:1124040134
Name:SHOLAS, MAURICE GERALD (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MAURICE
Middle Name:GERALD
Last Name:SHOLAS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 JOHNSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-785-3800
Mailing Address - Fax:404-785-3808
Practice Address - Street 1:1001 JOHNSON FERRY RD
Practice Address - Street 2:1532 TULANE AVENUE
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-785-3800
Practice Address - Fax:404-785-3808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15781R207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA904330757FMedicaid
LA1465836Medicaid
GA904330757FMedicaid
4J207Medicare ID - Type Unspecified
GAH46667Medicare UPIN