Healthcare Provider Details

I. General information

NPI: 1235242934
Provider Name (Legal Business Name): RAHUL V SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

352 S DELSEA DR UNIT C
VINELAND NJ
08360-5308
US

IV. Provider business mailing address

352 S DELSEA DR UNIT C
VINELAND NJ
08360-5308
US

V. Phone/Fax

Practice location:
  • Phone: 856-690-1616
  • Fax:
Mailing address:
  • Phone: 856-690-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMA08542100
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME96545
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberLT 2765
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberME96545
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberMA08542100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: