Provider Demographics
NPI:1649409244
Name:SHAH, SHALINI MALA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:MALA
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:684 SIXES RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8721
Mailing Address - Country:US
Mailing Address - Phone:678-388-5485
Mailing Address - Fax:678-388-5489
Practice Address - Street 1:900 TOWNE LAKE PKWY STE 306
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1604
Practice Address - Country:US
Practice Address - Phone:770-852-7720
Practice Address - Fax:770-852-7721
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2018-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA68556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics