| Norcross Medical Clinic, Magnolia Medical Clinic | |
|
1235 Indian Trail Road Suite 200 Norcross GA 30093 | |
| (770) 931-1333 | |
| (770) 931-3111 |
| Full Name | Norcross Medical Clinic, Magnolia Medical Clinic |
|---|---|
| Speciality | Internal Medicine |
| Location | 1235 Indian Trail Road, Norcross, Georgia |
| Authorized Official Name and Position | Suresh H Shah (OWNER/PHYSICIAN) |
| Authorized Official Contact | 7709311333 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norcross Medical Clinic, Magnolia Medical Clinic Po Box 1553 Duluth GA 30096 Ph: (770) 931-1333 | Norcross Medical Clinic, Magnolia Medical Clinic 1235 Indian Trail Road Suite 200 Norcross GA 30093 Ph: (770) 931-1333 |
| NPI Number | 1184711517 |
|---|---|
| Provider Enumeration Date | 10/06/2006 |
| Last Update Date | 05/28/2015 |
| Medicare PECOS PAC ID | 2365423142 |
|---|---|
| Medicare Enrollment ID | O20040527000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184711517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Shashank C Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598716995 PECOS PAC ID: 1456317031 Enrollment ID: I20100329000965 |
| Provider Name | Shehnaz Makhani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720088511 PECOS PAC ID: 2264558204 Enrollment ID: I20100927001096 |
| Provider Name | Suresh Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629097472 PECOS PAC ID: 0143279653 Enrollment ID: I20110902000425 |
| Provider Name | Bijalben Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003472150 PECOS PAC ID: 2567791478 Enrollment ID: I20190830002963 |
| Provider Name | Ravi S Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215381710 PECOS PAC ID: 9638463110 Enrollment ID: I20200303002933 |
| Provider Name | Anita Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306548284 PECOS PAC ID: 9638524655 Enrollment ID: I20231011003274 |
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