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General NPI Number Information
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NPI Number | 1174780118
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Entity Type | Organization
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Legal Business Name | M.H. SHAH, M.D.
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Dates
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Enumeration Date | 05/19/2008
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 1148 S HILLSIDE ST STE 104
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City | WICHITA
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State | KS
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Zip | 67211-4005
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Country | US
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Telephone | 316-687-0006
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Fax | 316-687-0328
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Provider Business Mailing Address
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Address Line | 1148 S HILLSIDE ST STE 104
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City | WICHITA
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State | KS
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Zip | 67211-4005
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Country | US
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Telephone | 316-687-0006
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Fax | 316-687-0328
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | M. H. SHAH
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Credential | M.D.
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Telephone | 316-687-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 04-17352
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License Number State | KS
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