Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 251288 | NY |
N | 111NI0900X | Internist | 251288 | NY |
Y | 207RG0100X | Gastroenterologist | 42590 | AZ |
NPI | 1003040981 |
---|---|
Provider Name | Dr. Akshay Vijay Shah |
First Address | Peoria, AZ 85381-5639 |
Second Address | Peoria, AZ 85381-5639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2009 |
Last Update Date | 28/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
509244 | (05) | AZ |