Provider Demographics
NPI:1427010560
Name:SHAY, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:SHAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:818 SAINT SEBASTIAN WAY
Mailing Address - Street 2:STE 300
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2651
Mailing Address - Country:US
Mailing Address - Phone:706-722-0186
Mailing Address - Fax:706-722-0290
Practice Address - Street 1:818 SAINT SEBASTIAN WAY
Practice Address - Street 2:STE 300
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2651
Practice Address - Country:US
Practice Address - Phone:706-722-0186
Practice Address - Fax:706-722-0290
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-02-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA040546207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000669677AMedicaid
SCQ20255Medicaid
GA000669677AMedicaid
GA11BDJRZMedicare PIN
SCC302197119Medicare PIN