MEDICARE: MANISH H 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	207R00000X	Internal Medicine Physician	D0061626	MD
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	MD037217	DC

General Provider Information

NPI Number	:	1750372629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANISH H SHAH MD

Provider Business Mailing Address
First Line	:	110 IRVING ST NW
Second Line	:	CARDIAC ARRHYTHMIA CENTER SUITE 5A-12
City	:	WASHINGTON
State	:	DC
Zip	:	20010-3017
Country	:	US
Telephone Number	:	202-877-7685
Fax Number	:	202-877-3455

Provider Business Practice Location Address
First Line	:	110 IRVING ST NW
Second Line	:	CARDIAC ARRHYTHMIA CENTER SUITE 5A-12
City	:	WASHINGTON
State	:	DC
Zip	:	20010-3017
Country	:	US
Telephone Number	:	202-877-7685
Fax Number	:	202-877-3455

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	11/20/2008

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Directions to “ MANISH H SHAH MD” Practice Location

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