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:
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Health care specialties

SpecialtyCodeLicense #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 10 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.

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Identifiers

StateTypeNumberIssuer
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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