Provider Demographics
NPI:1134346828
Name:SHAH, HEERAIN ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:HEERAIN
Middle Name:ASHOK
Last Name:SHAH
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 1:1325 SATELLITE BLVD NW BLDG 400
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4651
Mailing Address - Country:US
Mailing Address - Phone:678-263-3080
Mailing Address - Fax:678-496-9863
Practice Address - Street 1:1325 SATELLITE BLVD NW BLDG 400
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4651
Practice Address - Country:US
Practice Address - Phone:678-263-3080
Practice Address - Fax:678-496-9863
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA590162084P0804X
GA0590162084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV1986OtherSTATE LICENSE
NC2023-02697OtherSTATE LICENSE
GA59016OtherSTATE LICENSE