Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | GA040547 | GA |
NPI | 1023020799 |
---|---|
Provider Name | Anuradha N Sheth |
First Address | Lawrenceville, GA 30045-4317 |
Second Address | Lawrenceville, GA 30045-4317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2006 |
Last Update Date | 08/07/2007 |