| Evoked Ionm, Llc | |
|
6458 Meridian Way Sandy Springs GA 30328-2895 | |
| (678) 524-7388 | |
| (470) 407-6969 |
| Full Name | Evoked Ionm, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6458 Meridian Way, Sandy Springs, Georgia |
| Authorized Official Name and Position | Amit Shah (PRESIDENT, CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6785247388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Evoked Ionm, Llc 6458 Meridian Way Sandy Springs GA 30328-2895 Ph: () - | Evoked Ionm, Llc 6458 Meridian Way Sandy Springs GA 30328-2895 Ph: (678) 524-7388 |
| NPI Number | 1487133740 |
|---|---|
| Provider Enumeration Date | 08/08/2018 |
| Last Update Date | 04/12/2023 |
| Certification Date | 04/12/2023 |
| Medicare PECOS PAC ID | 7214288240 |
|---|---|
| Medicare Enrollment ID | O20250109002366 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487133740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0600X | Psychiatry & Neurology - Clinical Neurophysiology | (* (Not Available)) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Amit Deepak Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790028769 PECOS PAC ID: 3779834700 Enrollment ID: I20181001002374 |
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