Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 240071 | MA |
N | 207RC0000X | Internist - Cardiovascular Disease | 240071 | MA |
NPI | 1467619130 |
---|---|
Provider Name | Dr. Sachin Pramod Shah |
First Address | Burlington, MA 01805-0001 |
Second Address | Burlington, MA 01805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110085517A | (05) | MA |