ELITE SURGICAL PC NPI 1588094106

NPI Information

  • NPI: 1588094106
  • Provider Name: ELITE SURGICAL PC
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Other Name: BAHEEG L SHADEED MD
  • CLIA Number: 11D1072063
  • Address: 3969 S COBB DR SE STE 202
    SMYRNA, GA
    ZIP 30080
  • Phone: (770) 438-9191

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NPI Details

ELITE SURGICAL PC is a specialist in Smyrna, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ELITE SURGICAL PC NPI is 1588094106. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Baheeg L Shadeed Md.

The provider's business location address is:

3969 S COBB DR SE STE 202
SMYRNA, GA
ZIP 30080-317
Phone: (770) 438-9191
Fax: (770) 438-9272

The provider's authorized official is Baheeg Lawrence Shadeed .
The authorized official title is Owner and has the following contact phone number (770) 438-9191.

The CLIA number assigned to this NPI record is 11D1072063 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/18/2013 and was last updated on 1/15/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist024628GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1202I020826MEDICARE PINGEORGIA
2000261665BMEDICAIDGEORGIA
3202G700826MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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