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General NPI Number Information
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NPI Number | 1629311527
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Entity Type | Individual
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Provider Name | RONAK SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 433 PLAZA ST STE 1A&1B
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City | BOGALUSA
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State | LA
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Zip | 70427-3729
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Country | US
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Telephone | 985-730-7001
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Fax | 985-730-7006
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone |
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 307636
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License Number State | LA
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