| NPI | 1205201456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOBIN SHAH Owner 404-918-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| Enumeration Date | 2015-12-13 |
| Last Update Date | 2015-12-21 |