Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 42250 | AL |
NPI | 1053791467 |
---|---|
Provider Name | Diwas Shahi |
First Address | Huntsville, AL 35804-2705 |
Second Address | Huntsville, AL 35801-3580 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2015 |
Last Update Date | 29/04/2021 |