MEDICARE: MANE 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
1	207R00000X	Internal Medicine Physician	12786	NV
2	208M00000X	Hospitalist Physician	12786	NV

General Provider Information

NPI Number	:	1477714574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANE SHAH MD

Provider Business Mailing Address
First Line	:	2901 N TENAYA WAY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1420
Country	:	US
Telephone Number	:	702-852-2000
Fax Number	:	702-821-1704

Provider Business Practice Location Address
First Line	:	2901 N TENAYA WAY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-1420
Country	:	US
Telephone Number	:	702-852-2000
Fax Number	:	702-821-1704

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	04/20/2015

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Directions to “ MANE SHAH MD” Practice Location

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