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NPI Code Detail

MEDICARE: DR. MAYANK KANTILAL SHAH M.D.

MEDICARE: DR. MAYANK KANTILAL SHAH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician35-063565OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104894864
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAYANK KANTILAL SHAH M.D.
Provider Business Mailing Address
First Line : PO BOX 7527
Second Line :
City : DUBLIN
State : OH
Zip : 43017-0727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 278 BARKS RD W
Second Line :
City : MARION
State : OH
Zip : 43302-7367
Country : US
Telephone Number : 740-383-7980
Fax Number : 740-383-3040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2006
Last Update Date : 11/25/2024

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