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NPI Code Detail

MEDICARE: AMY SHAH M.D.

MEDICARE: AMY 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
1207R00000XInternal Medicine Physician246182NY
2207K00000XAllergy & Immunology Physician42638AZ

General Provider Information

NPI Number : 1376724500
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY SHAH M.D.
Provider Business Mailing Address
First Line : 9097 E DESERT COVE AVE STE 200
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85260-6280
Country : US
Telephone Number : 480-273-8510
Fax Number : 480-214-9933
Provider Business Practice Location Address
First Line : 18699 N 67TH AVE STE 300
Second Line :
City : GLENDALE
State : AZ
Zip : 85308-7149
Country : US
Telephone Number : 623-566-4718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2007
Last Update Date : 02/20/2021

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