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NPI Code Detail

MEDICARE: ATIF A SHAH MD

MEDICARE: ATIF A SHAH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianME134585FL
2208M00000XHospitalist PhysicianME134585FL

General Provider Information

NPI Number : 1164817805
Entity Type Code : Individual
Provider Name (Legal Business Name) : ATIF A SHAH MD
Provider Business Mailing Address
First Line : PO BOX 746638
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6638
Country : US
Telephone Number : 904-202-2092
Fax Number : 904-376-4075
Provider Business Practice Location Address
First Line : 820 PRUDENTIAL DR STE 304
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8205
Country : US
Telephone Number : 904-202-3860
Fax Number : 904-202-3846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2015
Last Update Date : 01/05/2026

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Directions to “ ATIF A SHAH MD” Practice Location

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