Healthcare Provider Details

I. General information

NPI: 1275791592
Provider Name (Legal Business Name): MONJRI MANHAR SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2008
Last Update Date: 06/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 BROOKWOOD MEDICAL CTR DR WOMEN'S MEDICAL PLAZA, SUITE 104
BIRMINGHAM AL
35209-6899
US

IV. Provider business mailing address

500 OFFICE PARK DR STE 400
MOUNTAIN BRK AL
35223-2457
US

V. Phone/Fax

Practice location:
  • Phone: 205-877-5100
  • Fax:
Mailing address:
  • Phone: 205-803-4330
  • Fax: 205-803-4354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number244876
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number30991
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: