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NPI Code Detail

MEDICARE: AMIT INDRAVADAN SHAH M.D.

MEDICARE: AMIT INDRAVADAN 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
1207RH0000XHematology (Internal Medicine) PhysicianME48069FL
2207RX0202XMedical Oncology PhysicianME48069FL

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 : 1407850449
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMIT INDRAVADAN SHAH M.D.
Provider Business Mailing Address
First Line : PO BOX 102222
Second Line : ATTN: CREDENTIAL DEPARTMENT
City : ATLANTA
State : GA
Zip : 30368-2222
Country : US
Telephone Number : 239-274-8200
Fax Number : 239-278-3350
Provider Business Practice Location Address
First Line : 1396 WHISPER CIR
Second Line :
City : SEBRING
State : FL
Zip : 33870-1204
Country : US
Telephone Number : 863-385-1244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 03/18/2026

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