Provider Demographics
NPI:1699708750
Name:SHROFF, MANISHA (MD)
Entity type:Individual
Prefix:DR
First Name:MANISHA
Middle Name:
Last Name:SHROFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:MANISHA
Other - Middle Name:SHROFF
Other - Last Name:CHIKHLIKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:106 VILLAGE GREEN CIR
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1519
Mailing Address - Country:US
Mailing Address - Phone:404-273-2290
Mailing Address - Fax:
Practice Address - Street 1:1525 CLIFTON RD NE
Practice Address - Street 2:RM 103-I
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4200
Practice Address - Country:US
Practice Address - Phone:404-727-0387
Practice Address - Fax:404-727-9086
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT98672084P0800X
NC2022-010872084P0800X
GA0541252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry