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General NPI Number Information
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NPI Number | 1396266102
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Entity Type | Individual
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Provider Name | NEHA SHAH
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Gender | Female
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Dates
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Enumeration Date | 06/30/2017
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 1 JEFFERSON BARRACKS RD
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City | SAINT LOUIS
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State | MO
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Zip | 63125-4181
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Country | US
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Telephone | 314-652-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 201 BENTLEY PL
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City | BELLEVILLE
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State | IL
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Zip | 62221-4435
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Country | US
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Telephone | 734-658-2844
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2021009168
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License Number State | MO
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