Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME105529 | FL |
N | 111NI0900X | Internist | ME105529 | FL |
Y | 207RX0202X | Medical Oncology | 2013021419 | MO |
N | 207RX0202X | Medical Oncology | NUMBER PENDING | NV |
NPI | 1023219698 |
---|---|
Provider Name | Dr. Atman Shah |
First Address | Joplin, MO 64803-3810 |
Second Address | Joplin, MO 64804-3651 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 19/07/2013 |