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NPI Code Detail

MEDICARE: JONAH SHAH MD

MEDICARE: JONAH 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
1207W00000XOphthalmology Physician2022021312MO
2207WX0107XRetina Specialist (Ophthalmology) Physician36936MS
3207WX0107XRetina Specialist (Ophthalmology) PhysicianE-20550AR
4207WX0107XRetina Specialist (Ophthalmology) Physician76947TN

General Provider Information

NPI Number : 1194458612
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONAH SHAH MD
Provider Business Mailing Address
First Line : 1432 KIMBROUGH RD
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-2405
Country : US
Telephone Number : 901-767-4499
Fax Number :
Provider Business Practice Location Address
First Line : 1432 KIMBROUGH RD
Second Line :
City : GERMANTOWN
State : TN
Zip : 38138-2405
Country : US
Telephone Number : 901-767-4499
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2022
Last Update Date : 06/12/2026

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