MEDICARE: AJIT 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	2085R0202X	Diagnostic Radiology Physician	MD036456E	PA
2	207U00000X	Nuclear Medicine Physician	TP163	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1245227735	OTHER		NPI
2	TP163	OTHER	KY	KENTUCKY MEDICAL LICENSE

General Provider Information

NPI Number	:	1245227735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AJIT SHAH MD

Provider Business Mailing Address
First Line	:	1615 BLACKBURN HEIGHTS DR.
Second Line	:
City	:	SEWICKLEY
State	:	PA
Zip	:	15143
Country	:	US
Telephone Number	:	412-324-1078
Fax Number	:	142-324-1079

Provider Business Practice Location Address
First Line	:	800 ROSE ST # HX332E
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40536-7001
Country	:	US
Telephone Number	:	859-323-5069
Fax Number	:	859-257-4457

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	03/17/2018

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Directions to “ AJIT SHAH MD” Practice Location

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