SHANEKKIA BLACK

AUSTELL, GA
NPI1164928545
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: GA  89381)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-04-04
Last Update Date2023-04-19
Business Address
SHANEKKIA BLACK MD
1605 MULKEY RD STE 220
AUSTELL, GA 30106-1127
Phone number: 470-956-3760
Mailing Address
SHANEKKIA BLACK MD
1605 MULKEY RD STE 220
AUSTELL, GA 30106-1127
Phone number: 470-956-3760