Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | C1-0011583 | DE |
N | 207RH0003X | Hematology & Oncology | P3446 | TX |
NPI | 1063743722 |
---|---|
Provider Name | Dhaval Rameshchandra Shah |
First Address | Newark, DE 19713-2055 |
Second Address | Newark, DE 19713-2055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2010 |
Last Update Date | 12/04/2016 |