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General NPI Number Information
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NPI Number | 1558822528
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Entity Type | Individual
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Provider Name | RONAK SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 03/30/2019
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 301 4TH ST STE 3H
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8411
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Country | US
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Telephone | 318-441-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 301 4TH ST STE 3H
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City | ALEXANDRIA
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State | LA
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Zip | 71301-8411
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Country | US
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Telephone | 318-441-1030
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME155035
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME155035
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | LA-320203
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License Number State | LA
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