Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 43588 | TN |
NPI | 1184870958 |
---|---|
Provider Name | Namrata Samir Shah |
First Address | Memphis, TN 38105 |
Second Address | Memphis, TN 38103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2008 |
Last Update Date | 30/06/2018 |