Provider Demographics
NPI:1427260355
Name:SHAH, FRINI (MD)
Entity type:Individual
Prefix:
First Name:FRINI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 PROFESSIONAL WAY
Mailing Address - Street 2:BLDG 200
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-3879
Mailing Address - Country:US
Mailing Address - Phone:770-517-0250
Mailing Address - Fax:770-517-0260
Practice Address - Street 1:2000 PROFESSIONAL WAY
Practice Address - Street 2:BLDG 200
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3879
Practice Address - Country:US
Practice Address - Phone:770-517-0250
Practice Address - Fax:770-517-0260
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA057489208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics