Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 024125E | PA |
NPI | 1003983065 |
---|---|
Provider Name | Dr. Mukesh Vasantlal Shah |
First Address | Pittsburgh, PA 15241-0328 |
Second Address | Charleroi, PA 15022-2141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0008842650006 | (05) | PA |
C33335 | (02) | PA |