GWINNETT CLINIC


Address: 3340 Peachtree Rd Ne, Ste 2025, Atlanta, GA 30326-1000
Phone: 7709953300

GWINNETT CLINIC (NPI# 1952676496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1952676496
Entity Type Organization
Organization Name GWINNETT CLINIC
Other Organization Name GWINNETT CLINIC , LTD
Practice Address 3340 Peachtree Rd Ne
Ste 2025
Atlanta
GA 30326-1000
Mailing Address 475 Philip Blvd
Ste 100
Lawrenceville
GA 30046-8737
Practice Telephone 7709953300
Practice Fax Number 7709953307
Mailing Telephone 7709953300
Mailing Fax Number 7709953307
Enumeration Date 2012-03-16
Last Update Date 2012-08-21
Authorized Official Name DR. JAYENDRAKUMAR J SHAH (PRESIDENT)
Authorized Official Telephone 7709953300
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 173000000X Legal Medicine Other Service Providers

Other Provider/Organization Names

Other Name Type Code
GWINNETT CLINIC , LTD Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1215005715 Gwinnett Clinic Legal Medicine 1740 Lawrenceville Hwy, Lawrenceville, GA 30044 2006-12-01

Office Location

Street Address 3340 PEACHTREE RD NE
STE 2025
City ATLANTA
State GA
Zip Code 30326-1000

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Taxonomy Information

Taxonomy Code 173000000X
Grouping Other Service Providers
Classification Legal Medicine

Taxonomy Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.
Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988.

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NPI Name Taxonomy Address Enumeration
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1215112321 Tina M. Mason, M.d., L.L.C. Legal Medicine 935 River Centre Pl, Suite 200, Lawrenceville, GA 30043-7322 2008-01-08
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Competitor

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City ATLANTA
Zip Code 30326

Improve Information

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Dataset Information

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.

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