ELITE SURGICAL PC (NPI# 1588094106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588094106 |
| Entity Type | Organization |
| Organization Name | ELITE SURGICAL PC |
| Other Organization Name | BAHEEG L SHADEED MD |
| Practice Address |
3969 S Cobb Dr Se Ste 202 Smyrna GA 30080-6317 |
| Practice Telephone | 7704389191 |
| Practice Fax Number | 7704389272 |
| Mailing Telephone | 7704389191 |
| Mailing Fax Number | 7704389272 |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2014-01-15 |
| Authorized Official Name | BAHEEG LAWRENCE SHADEED (OWNER) |
| Authorized Official Telephone | 7704389191 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 024628 | GA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000261665B | 05 |
| Other Name | Type Code |
|---|---|
| Baheeg L Shadeed MD | Other Name - Individual/Organization |
| Street Address |
3969 S COBB DR SE STE 202 |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-6317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093825846 | Thomas John Demarco | Internal Medicine | 3969 S Cobb Dr Se Ste 202, Smyrna, GA 30080-6317 | 2006-08-30 |
| 1922295617 | Thomas J. Demarco | Internal Medicine | 3969 S Cobb Dr Se Ste 202, Smyrna, GA 30080-6317 | 2007-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013332790 | Lisa Sanchez | Specialist | 1955 Lake Park Dr Se, Suite 300, Smyrna, GA 30080-8858 | 2014-03-04 |
| 1801047493 | Smyrna Pain Consultants, P.C. | Specialist | 1450 Sam Davis Rd Ste 170, Smyrna, TN 37167-2737 | 2008-10-01 |
| 1336324839 | Douglas Smith | Specialist | 1520 Collier Pl Se, Smyrna, GA 30080-4400 | 2008-01-02 |
| 1871790410 | Psychiatric Medical Specialist of Atlanta | Specialist | 4015 S Cobb Dr Se Ste 10, Smyrna, GA 30080-6315 | 2007-06-28 |
| 1558564021 | Cedar Grove Medical Associates,llc | Specialist | 301 Wolverine Trail, Suite 100, Smyrna, TN 37167 | 2007-06-11 |
| 1063614626 | Duane Taylor | Specialist | 5158 Afton Way Se, Smyrna, GA 30080-2669 | 2007-06-04 |
| 1083706071 | Seymour Solodar | Specialist | 4015 South Cobb Dr., Ste. 10, Smyrna, GA 30080 | 2006-09-28 |
| 1942259650 | Gina Elizabeth Hamrang | Specialist | 741 President Pl Ste 250, Smyrna, TN 37167-6812 | 2006-05-09 |
| 1316910615 | Priti Pandya | Specialist | 4441 Atlanta Rd Se Ste 204, Smyrna, GA 30080 | 2006-02-08 |
| 1225020639 | Martin I Goldstein | Specialist | 3001 S Cobb Dr Se, Suite 203, Smyrna, GA 30080-7809 | 2005-08-22 |
| Find all providers in SMYRNA | ||||
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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.