Provider Demographics
NPI:1366681843
Name:SHAH, AMIT JASVANT (MD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:JASVANT
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:80 JESSE HILL JR DR SE
Mailing Address - Street 2:CARDIOLOGY ADULT CLINIC, 2ND FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-3031
Mailing Address - Country:US
Mailing Address - Phone:404-616-4425
Mailing Address - Fax:888-530-4683
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:CARDIOLOGY ADULT CLINIC, 2ND FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-4425
Practice Address - Fax:888-530-4683
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2010-10-07
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Provider Licenses
StateLicense IDTaxonomies
GA62770261Q00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center