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General NPI Number Information
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NPI Number | 1578874590
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Entity Type | Individual
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Provider Name | NEELAM SHAH FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/24/2010
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Last Update Date | 04/17/2017
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Provider Practice Location Address
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Address Line | 6785 BUSINESS PKWY
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City | ELKRIDGE
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State | MD
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Zip | 21075-6353
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Country | US
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Telephone | 410-401-5485
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Fax |
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Provider Business Mailing Address
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Address Line | 8771 SUSINI DR
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City | LAUREL
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State | MD
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Zip | 20723-1225
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Country | US
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Telephone | 732-801-6617
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN1019757
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024168562
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R225940
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License Number State | MD
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