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NPI Code Detail

MEDICARE: NATASHA SHAH MD

MEDICARE: NATASHA 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
1207Q00000XFamily Medicine Physician77788MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609822394
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATASHA SHAH MD
Provider Business Mailing Address
First Line : 1069 BROADWAY
Second Line :
City : SAUGUS
State : MA
Zip : 01906
Country : US
Telephone Number : 781-233-1450
Fax Number : 781-233-1100
Provider Business Practice Location Address
First Line : 1069 BROADWAY
Second Line :
City : SAUGUS
State : MA
Zip : 01906-3210
Country : US
Telephone Number : 781-233-1450
Fax Number : 781-233-1100
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 02/02/2012

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Directions to “ NATASHA SHAH MD” Practice Location

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