Provider Demographics
NPI:1578993440
Name:DAI, SHENGCHUAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHENGCHUAN
Middle Name:
Last Name:DAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:684 SIXES RD STE 230
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8758
Mailing Address - Country:US
Mailing Address - Phone:404-962-6000
Mailing Address - Fax:404-962-6001
Practice Address - Street 1:684 SIXES RD STE 230
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-8758
Practice Address - Country:US
Practice Address - Phone:404-962-6000
Practice Address - Fax:404-962-6001
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLTRN19007207R00000X
GA00000207RC0000X
MI43011117461207RI0011X
GA86547207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology