MEDICARE: MUKUL R SHAH M.D.

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
1	2080N0001X	Neonatal-Perinatal Medicine Physician	33080	KY

General Provider Information

NPI Number	:	1295704385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUKUL R SHAH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 776879
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6879
Country	:	US
Telephone Number	:	502-272-5395
Fax Number	:	502-272-5339

Provider Business Practice Location Address
First Line	:	4123 DUTCHMANS LN STE 606
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40207-4725
Country	:	US
Telephone Number	:	502-896-2500
Fax Number	:	502-896-2527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	09/13/2021

Similar Medicare Providers

1841618766 — KRISTIN ELIZABETH REEVE M.D.
Practice Location Address:

4123 DUTCHMANS LN STE 606
LOUISVILLE, KY
40207-4725

Practice Phone: 502-899-6900
Practice Fax: 502-899-6905

1235203969 — JANICE FAYE STRINGER ARNP
Practice Location Address:

4123 DUTCHMANS LN STE 606
LOUISVILLE, KY
40207-4725

Practice Phone: 502-899-6900
Practice Fax: 502-899-6905

1730243239 — KENNETH BRIAN COX KCSA
Practice Location Address:

4123 DUTCHMANS LN STE 607
LOUISVILLE, KY
40207-4725

Practice Phone: 502-899-6479
Practice Fax: 502-899-6479

1750553665 — DR. ANKUR DATTA M.D.
Practice Location Address:

4123 DUTCHMANS LN STE 606
LOUISVILLE, KY
40207-4725

Practice Phone: 502-896-2500
Practice Fax:

1144554957 — MS. KELLY M JOY PA-C
Practice Location Address:

4123 DUTCHMANS LN STE 607
LOUISVILLE, KY
40207-4725

Practice Phone: 502-899-6470
Practice Fax: 502-899-6479

1306152939 — ANSEL TSUNG JIN TJIN-A-TAM M.D
Practice Location Address:

4123 DUTCHMANS LN STE 606
LOUISVILLE, KY
40207-4725

Practice Phone: 502-896-2500
Practice Fax: 502-896-2527

Directions to “ MUKUL R SHAH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.