Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | NV10134 | NV |
Y | 208600000X | Surgeon | NV10134 | NV |
N | 2082S0105X | Plastic Hand Surgeon | NV 10134 | NV |
NPI | 1417935065 |
---|---|
Provider Name | Dr. Himansu R Shah |
First Address | Henderson, NV 89052-4188 |
Second Address | Henderson, NV 89052-4188 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2006 |
Last Update Date | 09/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002018548 | (05) | NV |
BS4703321 | DEA (01) | NV |
CS11151 | PHARMACY/CDS (01) | NV |
G21421 | (02) | NV |