Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 21493 | AZ |
N | 111NI0900X | Internist | 21493 | AZ |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 21493 | AZ |
N | 207U00000X | Nuclear Medicine Specialist | 21493 | AZ |
NPI | 1528175072 |
---|---|
Provider Name | Dr. Jayendra H Shah |
First Address | Tucson, AZ 85718-1203 |
Second Address | Tucson, AR 85723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |