SHUVRO DE (NPI# 1508125865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508125865 |
| Entity Type | Individual |
| Full Name | SHUVRO DE |
| Credential | MD |
| Practice Address |
5730 Glenridge Dr Ste 200 Atlanta GA 30328-5579 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 4042525206 |
| Mailing Telephone | 6782844686 |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2019-05-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2088P0231X |
Urology Specialization: Pediatric Urology |
82744 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
5730 GLENRIDGE DR STE 200 |
| City | ATLANTA |
| State | GA |
| Zip Code | 30328-5579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710089404 | Mark A Haber | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2006-09-02 |
| 1679137467 | Shannon Suarez | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2019-04-26 |
| 1336623222 | Beniam Tefera Abebe | Physician Assistant | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2018-09-18 |
| 1194230961 | Carrie Collin | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328 | 2017-12-02 |
| 1770093213 | Callie Denmark Duggan | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2017-10-11 |
| 1033635925 | Stephanie Ottimo | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328 | 2017-08-22 |
| 1851821805 | Kristin L Wellman | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2017-06-13 |
| 1578925129 | Jennifer Garner | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2016-03-23 |
| 1003244013 | Andrea Mitchell Center | Nurse Practitioner | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2013-10-30 |
| 1740520543 | Karmon Janssen | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2013-02-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467910042 | Amber Andrews | Behavior Technician | 750 Hammond Drive Bldg 7 Suite 100, Atlanta, GA 30328 | 2019-03-04 |
| 1215492830 | Ryan William Dubinin | Behavior Technician | 750 Hammond Drive, Building 7, Suite 100, Atlanta, NJ 30328 | 2019-02-07 |
| 1346710142 | Emily Rose Lloyd Swavely | Speech-Language Pathologist | 5825 Glenridge Rd., Building 1, Suite 133, Atlanta, GA 30328 | 2018-12-05 |
| 1063994481 | Mark Edward Brachmanski | Optometrist | 800 Mount Vernon Highway Ne, Suite 130, Atlanta, GA 30328 | 2018-09-01 |
| 1407352578 | Nina Brown | Massage Therapist | 7100 Peachtree Dunwoody Rd Ste 110, Sandy Springs, GA 30328 | 2018-04-05 |
| 1336657741 | Renee Usher Reeves | Assistant Behavior Analyst | 750 Hammond Dr Building 7, Suite 100, Atlanta, GA 30328 | 2018-01-19 |
| 1487168274 | Patricia Nicole Felder | Student in an Organized Health Care Education/Training Program | 270 Carpenter Dr, Ne, Suite # 400, Atlanta, GA 30328 | 2017-12-01 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1770093601 | Syed M Rasheed | Physician Assistant | 5788 Roswell Rd Ste 100, Atlanta, GA 30328 | 2017-10-05 |
| 1437678190 | Jeanette Denise Jones | Counselor | 270 Carpenter Drive, Suite 400, Sandy Springs, GA 30328 | 2017-09-13 |
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| Taxonomy Code | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770942856 | Georgia Urology Pediatric LLC | Urology | 5730 Glenridge Dr, Ste 200, Atlanta, GA 30328-6141 | 2016-02-17 |
| 1912137431 | Emily Blum | Urology | 5730 Glenridge Dr Ste 200, Atlanta, GA 30328-5579 | 2009-07-17 |
| 1891993374 | Wolfgang Hans Cerwinka | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2007-07-06 |
| 1174749055 | Georgia Urology Pa | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2007-04-18 |
| 1427152982 | Bruce H Broecker | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1336243898 | Andrew J Kirsch | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1699879155 | Hal C Scherz | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1245334705 | Charlotte A Massad | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-09-12 |
| 1821019076 | Georgia Urology Pediatric LLC | Urology | 5445 Meridian Marks Rd Ne, Suite 420, Atlanta, GA 30342-4763 | 2006-07-22 |
| 1336174085 | James Michael Elmore | Urology | 5445 Meridian Marks Rd, Suite 420, Atlanta, GA 30342-4763 | 2006-07-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.