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NPI Code Detail

MEDICARE: DR. HETAL C SHAH M.D.

MEDICARE: DR. HETAL C 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
1207VM0101XMaternal & Fetal Medicine Physician25006AZ
2207VX0000XObstetrics Physician25006AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750363255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HETAL C SHAH M.D.
Provider Business Mailing Address
First Line : 4700 N 51ST AVE STE 5
Second Line :
City : PHOENIX
State : AZ
Zip : 85031-1237
Country : US
Telephone Number : 623-846-7597
Fax Number : 623-846-1826
Provider Business Practice Location Address
First Line : 4700 N 51ST AVE STE 5
Second Line :
City : PHOENIX
State : AZ
Zip : 85031-1237
Country : US
Telephone Number : 623-846-7597
Fax Number : 623-846-1826
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 03/07/2023

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Directions to “ DR. HETAL C SHAH M.D.” Practice Location

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