Provider Demographics
NPI:1477785186
Name:WADA, MOHAMMED SHAZAD (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:SHAZAD
Last Name:WADA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3333 OLD MILTON PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4437
Mailing Address - Country:US
Mailing Address - Phone:770-391-3979
Mailing Address - Fax:770-391-0020
Practice Address - Street 1:3333 OLD MILTON PKWY STE 400
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4437
Practice Address - Country:US
Practice Address - Phone:770-391-3979
Practice Address - Fax:770-391-0020
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2019-02-04
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Provider Licenses
StateLicense IDTaxonomies
GA063043207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine