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General NPI Number Information
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NPI Number | 1902693294
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Entity Type | Individual
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Provider Name | NADER SHAH DO
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Gender | Male
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 101 E LAUREL RD STE B
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City | STRATFORD
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State | NJ
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Zip | 08084-1324
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Country | US
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Telephone | 609-781-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 4535 PEBBLE BEACH DR
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City | STOCKTON
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State | CA
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Zip | 95219-1909
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Country | US
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Telephone | 209-986-4975
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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