Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD2015-0598 | NM |
N | 111NI0900X | Internist | MD2015-0598 | NM |
Y | 207RH0003X | Hematology & Oncology | MD2015-0598 | NM |
NPI | 1023252665 |
---|---|
Provider Name | Namrata Shah |
First Address | Avon, IN 46123-7085 |
Second Address | Avon, IN 46123-7085 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2009 |
Last Update Date | 29/03/2021 |