Healthcare Provider Details

I. General information

NPI: 1992972590
Provider Name (Legal Business Name): PARTHIV SHAH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 CHESTNUT STATION CT
LOUISVILLE KY
40299-6395
US

IV. Provider business mailing address

9504 W PRITCHARD CT
YORKTOWN IN
47396-8003
US

V. Phone/Fax

Practice location:
  • Phone: 800-335-1060
  • Fax:
Mailing address:
  • Phone: 765-702-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number05009512A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05009512A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: