MEDICARE: DR. RAHIL DEVENDRA 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
1	207RG0100X	Gastroenterology Physician	MD.204420	LA
2	207RG0100X	Gastroenterology Physician	MD0000039491	TN

Other Identifiers

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

General Provider Information

NPI Number	:	1235172651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAHIL DEVENDRA SHAH M.D.

Provider Business Mailing Address
First Line	:	5959 S SHERWOOD FOREST BLVD
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70816-6038
Country	:	US
Telephone Number	:	225-765-5727
Fax Number	:	225-765-9196

Provider Business Practice Location Address
First Line	:	1014 SAINT CLAIR BLVD STE 3030
Second Line	:
City	:	GONZALES
State	:	LA
Zip	:	70737-5023
Country	:	US
Telephone Number	:	225-765-5500
Fax Number	:	225-743-2546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	05/13/2025

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