Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA08991700 | NJ |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD447960 | PA |
NPI | 1083881023 |
---|---|
Provider Name | Dr. Salil Gitesh Shah |
First Address | Philadelphia, PA 19178-8735 |
Second Address | Philadelphia, PA 19141-3018 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2008 |
Last Update Date | 18/04/2013 |