Provider Demographics
NPI:1861651739
Name:SHIEH, CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:SHIEH
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 1:2675 N DECATUR RD STE 710
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6135
Mailing Address - Country:US
Mailing Address - Phone:404-292-4348
Mailing Address - Fax:404-501-0660
Practice Address - Street 1:2675 N DECATUR RD STE 710
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6135
Practice Address - Country:US
Practice Address - Phone:404-292-4348
Practice Address - Fax:404-501-0660
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA76970208G00000X
CAA126726208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)