Healthcare Provider Details

I. General information

NPI: 1215927892
Provider Name (Legal Business Name): PARAGI R SHAH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 12/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19646 N 27TH AVE STE 403
PHOENIX AZ
85027-4017
US

IV. Provider business mailing address

1760 E RIVER RD STE. 350
TUCSON AZ
85718-5877
US

V. Phone/Fax

Practice location:
  • Phone: 623-587-4868
  • Fax: 623-582-5300
Mailing address:
  • Phone: 520-519-7775
  • Fax: 520-519-7910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number3279
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: