Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD16227 | RI |
NPI | 1043653116 |
---|---|
Provider Name | Dr. Ankur Shah |
First Address | Providence, RI 02903-4626 |
Second Address | Riverside, RI 02915-2235 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2013 |
Last Update Date | 10/12/2020 |