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General NPI Number Information
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NPI Number | 1952462350
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Entity Type | Organization
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Legal Business Name | SIDDHARTH H SHAH MD PA
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 4762 ROWAN RD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34653-5601
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Country | US
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Telephone | 727-848-0800
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Fax | 727-843-8157
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Provider Business Mailing Address
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Address Line | PO BOX 768
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City | ELFERS
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State | FL
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Zip | 34680-0768
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Country | US
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Telephone | 727-848-0800
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Fax | 727-843-8157
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Authorized Official
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Title or Position | PRESIDENT
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Name | SIDDHARTH H SHAH
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Credential | MD
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Telephone | 727-848-0800
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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 |
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License Number State |
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