Search › Georgia › 363A00000X
Shandra Hart, PA-C
NPI 1124611017 · on the registry since 2021 · sole proprietor
Practice
- Address
- 116 Upper Riverdale Rd Sw
Riverdale, GA 30274 - Phone
- (404) 564-7042
- Fax
- (404) 241-6256
- Organisation at this address
- Southside Medical Center, Inc.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363A00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-11-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia