Provider Demographics
NPI:1265966121
Name:SHI, WEILONG JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:WEILONG
Middle Name:JEFFREY
Last Name:SHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:SHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:900 CIRCLE 75 PKWY SE STE 1700
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-3087
Mailing Address - Country:US
Mailing Address - Phone:770-953-6929
Mailing Address - Fax:
Practice Address - Street 1:1301 SIGMAN RD NE STE 125
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3820
Practice Address - Country:US
Practice Address - Phone:678-413-6276
Practice Address - Fax:678-413-6277
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA95982207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery