Healthcare Provider Details

I. General information

NPI: 1407815889
Provider Name (Legal Business Name): MANISH H SHAH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4545 E 9TH AVE STE 490
DENVER CO
80220-3901
US

IV. Provider business mailing address

4545 E 9TH AVE STE 490
DENVER CO
80220-3901
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-3791
  • Fax:
Mailing address:
  • Phone: 303-399-3791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MANISH H SHAH
Title or Position: PHYSICIAN
Credential: MD
Phone: 303-399-3791