Healthcare Provider Details

I. General information

NPI: 1053931410
Provider Name (Legal Business Name): PIR ALI SHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2020
Last Update Date: 08/19/2025
Certification Date: 08/19/2025
Deactivation Date: 01/10/2022
Reactivation Date: 02/03/2022

III. Provider practice location address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

IV. Provider business mailing address

400 S SANTA FE AVE
SALINA KS
67401-4144
US

V. Phone/Fax

Practice location:
  • Phone: 785-452-6113
  • Fax: 785-452-6119
Mailing address:
  • Phone: 785-452-6113
  • Fax: 785-452-6119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number04-50589
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-50589
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: