Provider Demographics
NPI:1750540233
Name:MAITHEL, SHISHIR K (MD)
Entity type:Individual
Prefix:
First Name:SHISHIR
Middle Name:K
Last Name:MAITHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1365 C CLIFTON RD NE
Mailing Address - Street 2:SUITE C2018 2ND FL
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:404-778-1903
Mailing Address - Fax:404-778-4490
Practice Address - Street 1:101W PONCE DE LEON AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2528
Practice Address - Country:US
Practice Address - Phone:404-778-5014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2024-11-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0361714772086X0206X
GA0627392086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology