NPI 1407090459

Edan Shapiro, MD

Practitioner Urology Physician Fayetteville, GA

Practice location

Address: 1336 Highway 54 W Bldg 200, Fayetteville, GA 30214-4535
Phone: (770) 460-9777
Fax: (770) 460-0650
Mailing address: 1930 Brannan Rd, McDonough, GA 30253-4310

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 73486 (GA)

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Registry record

NPI: 1407090459
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Apr 2009
Record last updated: 19 Jun 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.