Healthcare Provider Details

I. General information

NPI: 1437325511
Provider Name (Legal Business Name): PAYAL SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAYAL SHAH M.D.

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 12/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 PATTERSON ST SUITE 311
NASHVILLE TN
37203-1562
US

IV. Provider business mailing address

500 RIVERCREST CV
NASHVILLE TN
37214-2580
US

V. Phone/Fax

Practice location:
  • Phone: 615-342-6830
  • Fax: 615-342-8636
Mailing address:
  • Phone: 615-496-3701
  • Fax: 615-874-8478

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number46455
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: