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General NPI Number Information
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NPI Number | 1265457485
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Entity Type | Individual
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Provider Name | ANIMESH CHANDULAL SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 65 E INDIA ROW APT 33C
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City | BOSTON
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State | MA
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Zip | 02110-3323
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Country | US
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Telephone | 952-595-1100
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Fax | 952-942-3361
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Provider Business Mailing Address
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Address Line | 11995 SINGLETREE LN SUITE 500
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-5347
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Country | US
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Telephone | 952-595-1100
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Fax | 952-942-3361
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C52320
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME94621
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 431246
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | D63709
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License Number State | MD
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Taxonomy #5
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 227088
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License Number State | MA
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Taxonomy #6
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 50336
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License Number State | WI
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Taxonomy #7
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101242324
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License Number State | VA
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