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General NPI Number Information
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NPI Number | 1275952178
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Entity Type | Individual
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Provider Name | CHANDRESH SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 234 E GRAY ST STE 850
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City | LOUISVILLE
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State | KY
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Zip | 40202-1901
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Country | US
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Telephone | 502-629-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 950121
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City | LOUISVILLE
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State | KY
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Zip | 40295-0121
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Country | US
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Telephone | 205-542-5065
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Fax | 205-547-2902
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 54158
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License Number State | KY
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