Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0120X | Pediatric Surgery | 04-35084 | KS |
Y | 2086S0120X | Pediatric Surgery | 2011016082 | MO |
NPI | 1447416466 |
---|---|
Provider Name | Dr. Sohail R. Shah |
First Address | Kansas City, MO 64108-4619 |
Second Address | Kansas City, MO 64108-4619 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2008 |
Last Update Date | 12/08/2013 |