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General NPI Number Information
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NPI Number | 1821090085
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Entity Type | Individual
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Provider Name | HIMANSHU SHAH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 06/26/2024
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Provider Practice Location Address
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Address Line | 801 SAINT MARYS DR SUITE 502 EAST
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City | EVANSVILLE
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State | IN
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Zip | 47714-0511
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Country | US
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Telephone | 812-485-1785
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Fax | 812-485-1890
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Provider Business Mailing Address
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Address Line | 3700 BELLEMEADE AVE STE 117
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City | EVANSVILLE
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State | IN
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Zip | 47714-0106
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Country | US
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Telephone | 812-437-4333
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Fax | 812-437-4335
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01036039A
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License Number State | IN
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