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General NPI Number Information
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NPI Number | 1861752529
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Entity Type | Individual
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Provider Name | NEEL NITIN SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 03/31/2024
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Provider Practice Location Address
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Address Line | 400 ROSALIND REDFERN GROVER PKWY STE 120
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City | MIDLAND
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State | TX
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Zip | 79701-5849
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Country | US
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Telephone | 432-221-5970
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Fax | 866-634-3322
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Provider Business Mailing Address
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Address Line | 300 E MCBEE AVE FL 4
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City | GREENVILLE
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State | SC
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Zip | 29601-2842
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Country | US
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Telephone | 864-522-8603
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | Q7470
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 40680
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | Q7470
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License Number State | TX
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