Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 06992 | GA |
Y | 207N00000X | Dermatologist | ME142105 | FL |
NPI | 1043447360 |
---|---|
Provider Name | Dr. Asha Patel Shah |
First Address | Atlanta, GA 30306-3656 |
Second Address | Tampa, FL 33614-3972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2009 |
Last Update Date | 23/12/2020 |