Provider Demographics
NPI:1528384385
Name:BABALIAROS, KATHERINE SHIELDS (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:SHIELDS
Last Name:BABALIAROS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:LYNN
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5780 PEACHTREE DUNWOODY RD
Mailing Address - Street 2:SUITE 195
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1554
Mailing Address - Country:US
Mailing Address - Phone:770-751-3600
Mailing Address - Fax:770-399-2803
Practice Address - Street 1:5780 PEACHTREE DUNWOODY RD
Practice Address - Street 2:SUITE 195
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1554
Practice Address - Country:US
Practice Address - Phone:770-751-3600
Practice Address - Fax:770-399-2803
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4613207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA71940OtherPHYSICIAN LICENSE
GA003147544CMedicaid
GA003147544DMedicaid
GA003147544AMedicaid
GA003147544BMedicaid