| Anand T Shantha, MD | |
|
119 N Park Trl, Stockbridge, GA 30281-7373 | |
| (770) 389-3739 | |
| (770) 389-6565 |
| Full Name | Anand T Shantha |
|---|---|
| Gender | Male |
| Speciality | Urology |
| Location | 119 N Park Trl, Stockbridge, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225047301 | NPI | - | NPPES |
| 340020189 | Other | GA | RAILROAD MEDICARE |
| 000972804A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | 050677 (Georgia) | Primary |
| Entity Name | Georgia Urology, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245250646 PECOS PAC ID: 8921094376 Enrollment ID: O20040422000123 |
| Entity Name | Urological Professional Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033521810 PECOS PAC ID: 9638391717 Enrollment ID: O20141104002579 |
| Mailing Address | Practice Location Address |
|---|---|
| Anand T Shantha, MD 1930 Brannan Rd, Mcdonough, GA 30253-4310 Ph: (678) 284-4040 | Anand T Shantha, MD 119 N Park Trl, Stockbridge, GA 30281-7373 Ph: (770) 389-3739 |
Mauro Folgosa, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 290 Country Club Dr, Suite 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
James Van Eaton, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Jonathan Zurawin, Urology Medicare: Accepting Medicare Assignments Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Robert Scott Libby, MD Urology Medicare: Medicare Enrolled Practice Location: 180 N Park Trl Ste 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Varon Alexander Garcias, MD Urology Medicare: Not Enrolled in Medicare Practice Location: 290 Country Club Dr, Suite 100, Stockbridge, GA 30281 Phone: 770-474-5281 Fax: 770-389-8674 | |
Dr. Bhavik Shah, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 175 Country Club Dr Ste 300-e, Stockbridge, GA 30281 Phone: 678-941-4140 Fax: 678-941-4139 |