| Dr Shelley Machuta Fernandes, MD | |
|
1100 Northside Forsyth Dr, Ste 140, Cumming, GA 30041-6012 | |
| (770) 292-7000 | |
| (770) 292-7002 |
| Full Name | Dr Shelley Machuta Fernandes |
|---|---|
| Gender | Female |
| Speciality | Radiology - Radiation Oncology |
| Location | 1100 Northside Forsyth Dr, Cumming, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639153828 | NPI | - | NPPES |
| 000929585B | Medicaid | GA | |
| 457240757A | Medicaid | GA | |
| 000929585V | Medicaid | GA | |
| 000929585D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0001X | Radiology - Radiation Oncology | 044272 (Georgia) | Primary |
| Entity Name | Radiotherapy Clinics Of Georgia,llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851449540 PECOS PAC ID: 7911909486 Enrollment ID: O20070213000238 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shelley Machuta Fernandes, MD 1100 Northside Forsyth Dr, Ste 140, Cumming, GA 30041-6012 Ph: (770) 292-7000 | Dr Shelley Machuta Fernandes, MD 1100 Northside Forsyth Dr, Ste 140, Cumming, GA 30041-6012 Ph: (770) 292-7000 |
Dr. Stephen Hale Falwell, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 3161 Neal Ct, Cumming, GA 30041 Phone: 770-406-8476 | |
Dr. Edmund Lloyd Simon, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1100 Northside Forsyth Dr, Ste 140, Cumming, GA 30041 Phone: 770-292-7000 Fax: 770-292-7002 |