Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | 45056 | MD |
N | 207RC0200X | Critical Care Medicine | 45057 | TN |
Y | 207RP1001X | Pulmonary Disease | 45056 | MD |
N | 207RP1001X | Pulmonary Disease | 45057 | TN |
NPI | 1073659561 |
---|---|
Provider Name | Dr. Pali Dedhiya Shah |
First Address | Baltimore, MD 21264-4264 |
Second Address | Baltimore, MD 21287-0006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 18/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
049034200 | (05) | MD |