MEDICARE: DR. ANKUR 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	2085R0202X	Diagnostic Radiology Physician	25MA09808900	NJ

General Provider Information

NPI Number	:	1346554870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANKUR SHAH M.D.

Provider Business Mailing Address
First Line	:	72 W JIMMIE LEEDS RD
Second Line	:	SUITE 1100
City	:	GALLOWAY
State	:	NJ
Zip	:	08205-9406
Country	:	US
Telephone Number	:	609-652-6815
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 N ROUTE 9
Second Line	:
City	:	CAPE MAY COURT HOUSE
State	:	NJ
Zip	:	08210-1960
Country	:	US
Telephone Number	:	609-677-9729
Fax Number	:

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

Provider Enumeration Date	:	07/26/2010
Last Update Date	:	07/21/2016

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