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General NPI Number Information
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NPI Number | 1518905348
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Entity Type | Individual
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Provider Name | MINDY S SHAH MD
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 6737 W WASHINGTON ST STE 2150
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City | WEST ALLIS
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State | WI
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Zip | 53214-5649
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Country | US
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Telephone | 608-224-9371
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Fax |
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Provider Business Mailing Address
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Address Line | 50 S B B KING BLVD STE 100
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City | MEMPHIS
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State | TN
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Zip | 38103-2626
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Country | US
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Telephone | 866-949-0108
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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 | 231472
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 72725
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 20072
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License Number State | ND
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Taxonomy #4
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 231472
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 63930
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License Number State | WI
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Taxonomy #6
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 231472
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License Number State | NY
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