Provider Demographics
NPI:1861266892
Name:SHAH, PAYAL C
Entity type:Individual
Prefix:
First Name:PAYAL
Middle Name:C
Last Name:SHAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 10TH ST NE APT 6
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4294
Mailing Address - Country:US
Mailing Address - Phone:470-231-9052
Mailing Address - Fax:
Practice Address - Street 1:1 BALTIMORE PL NW STE 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2118
Practice Address - Country:US
Practice Address - Phone:470-231-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No251K00000XAgenciesPublic Health or Welfare