MEDICARE: DR. ASHINI 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	207R00000X	Internal Medicine Physician	30381	AZ

General Provider Information

NPI Number	:	1376521625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHINI SHAH M.D.

Provider Business Mailing Address
First Line	:	6200 N LA CHOLLA BLVD
Second Line	:	#206
City	:	TUCSON
State	:	AZ
Zip	:	85741-3529
Country	:	US
Telephone Number	:	520-469-8011
Fax Number	:	520-469-8021

Provider Business Practice Location Address
First Line	:	4729 E SUNRISE DR
Second Line	:	#398
City	:	TUCSON
State	:	AZ
Zip	:	85718-4534
Country	:	US
Telephone Number	:	520-469-8011
Fax Number	:	520-469-8021

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	05/10/2016

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