Provider Demographics
NPI:1982790754
Name:SHAH, ERA SIDHAYE (MD)
Entity Type:Individual
Prefix:DR
First Name:ERA
Middle Name:SIDHAYE
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:975 JOHNSON FY RD NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1619
Mailing Address - Country:US
Mailing Address - Phone:404-843-4000
Mailing Address - Fax:404-250-6701
Practice Address - Street 1:975 JOHNSON FY RD NE
Practice Address - Street 2:SUITE 400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1619
Practice Address - Country:US
Practice Address - Phone:404-843-4000
Practice Address - Fax:404-250-6701
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2020-08-28
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Provider Licenses
StateLicense IDTaxonomies
GA58778207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEK214ZMedicare PIN