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General NPI Number Information
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NPI Number | 1366937237
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Entity Type | Organization
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Legal Business Name | SHAH SURGICAL ASSISTING,LLC
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Dates
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Enumeration Date | 06/24/2018
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Last Update Date | 07/11/2018
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Provider Practice Location Address
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Address Line | 6455 E NELSON DR
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City | TUCSON
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State | AZ
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Zip | 85730
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Country | US
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Telephone | 520-282-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 6455 E NELSON DR
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City | TUCSON
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State | AZ
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Zip | 85730-3610
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Country | US
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Telephone | 520-282-1210
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Fax |
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Authorized Official
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Title or Position | SURGICAL FIRST ASSISTANT
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Name | MR. MUKESH N SHAH
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Credential | CSFA
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Telephone | 520-282-1210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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