Healthcare Provider Details

I. General information

NPI: 1689683914
Provider Name (Legal Business Name): SONA MAHENDRA SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9035 WADSWORTH PKWY STE 3000
WESTMINSTER CO
80021-8628
US

IV. Provider business mailing address

9035 WADSWORTH PKWY STE 3000
WESTMINSTER CO
80021-8628
US

V. Phone/Fax

Practice location:
  • Phone: 303-422-7677
  • Fax: 303-422-6029
Mailing address:
  • Phone: 303-422-7677
  • Fax: 303-422-6029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37219
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: