Simon, Shiju M

Simon, Shiju M is an individual health care provider with primary practice located at 1000 Medical Center Blvd , Lawrenceville GA 30046-7694. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Simon, Shiju M can be contacted via phone (678) 312-1000.

Contact Information

Primary practice address
1000 Medical Center Blvd Lawrenceville GA 30046-7694
Phone: (678) 312-1000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X AA287 Florida
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 9220 Georgia

Profile Details

NPI number 1942677919
LBN Legal business name Simon, Shiju M
Credentials AA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2015
Last updated Mar 22nd, 2023 - about 3 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 1942677919 NPPES
Florida MEDICAID 015893200

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