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General NPI Number Information
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NPI Number | 1376985630
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Entity Type | Individual
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Provider Name | NIKET SHAH D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 800 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5340
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Country | US
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Telephone | 304-424-2111
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Fax |
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Provider Business Mailing Address
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Address Line | 933 W VAN BUREN ST APT 405
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City | CHICAGO
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State | IL
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Zip | 60607-3582
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Country | US
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Telephone | 630-379-7859
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 02005005A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ED0400A
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 02005005A
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License Number State | IN
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