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1902085814
AZHAR S SHAH
TUCKER, GA
NPI
1902085814
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171W00000X Contractor
(Licence: MO 2007028770)
Enumeration Date
2007-10-26
Last Update Date
2007-10-26
Business Address
Mr. AZHAR S SHAH MSPT
1979 LAKESIDE PKWY STE. 250
TUCKER, GA 30084-5935
Phone number: 678-837-1252
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Mailing Address
Mr. AZHAR S SHAH MSPT
1979 LAKESIDE PKWY STE. 250
TUCKER, GA 30084-5935
Phone number: 678-837-1252
Copy
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