MEDICARE: DR. ABID SHAH MD

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	207P00000X	Emergency Medicine Physician		NC

General Provider Information

NPI Number	:	1245227222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ABID SHAH MD

Provider Business Mailing Address
First Line	:	9121 RIVERVIEW PARK DR
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27613-5385
Country	:	US
Telephone Number	:	919-624-9621
Fax Number	:

Provider Business Practice Location Address
First Line	:	566 RUIN CREEK RD
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-2927
Country	:	US
Telephone Number	:	252-436-1162
Fax Number	:

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	07/09/2007

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