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General NPI Number Information
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NPI Number | 1801243472
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Entity Type | Individual
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Provider Name | JINESH SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/24/2016
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Last Update Date | 11/06/2023
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Provider Practice Location Address
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Address Line | 9250 N 3RD ST STE 1003
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City | PHOENIX
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State | AZ
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Zip | 85020-2402
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Country | US
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Telephone | 602-830-8513
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208662
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City | DALLAS
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State | TX
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Zip | 75320-8662
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Country | US
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Telephone | 480-625-0003
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Fax | 480-842-8760
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 70412
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 70488
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License Number State | AZ
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