Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 01061039A | IN |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 81966 | SC |
N | 208G00000X | Cardiothoracic Vascular Surgeon | C55244 | CA |
NPI | 1083631600 |
---|---|
Provider Name | Sachin H Shah |
First Address | Columbia, SC 29202-3174 |
Second Address | Anderson, SC 29621-7915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 26/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200535940 | (05) | IN |
819662 | (05) | SC |
I43294 | (02) |