Shanik, Edward Joel
Shanik, Edward Joel is an individual health care provider with primary practice located at 260 Elm St , Cumming GA 30040-2467. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Shanik, Edward Joel can be contacted via phone (770) 887-1668.Contact Information
Primary practice address
260 Elm St
Cumming GA 30040-2467
Phone: (770) 887-1668
Fax: (770) 781-9937
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 020484 | Georgia |
Profile Details
| NPI number | 1417916859 |
|---|---|
| LBN Legal business name | Shanik, Edward Joel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Dec 22nd, 2014 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417916859 | NPPES |
| Georgia | MEDICAID | 000193179K | |
| Georgia | MEDICAID | 4048222 | |
| Georgia | MEDICAID | 00193179J | |
| Georgia | Other | 01160889 | |
| Georgia | Other | 52023332 | |
| Georgia | MEDICAID | 000193179L | |
| Georgia | MEDICAID | 000193179M | |
| Georgia | Other | 4186949 |
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