MEDICARE: SAPNA PATHAK 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	207RH0003X	Hematology & Oncology Physician	89781	SC

General Provider Information

NPI Number	:	1750918488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAPNA PATHAK SHAH MD

Provider Business Mailing Address
First Line	:	PO BOX 23321
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-4321
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1161 COOK RD
Second Line	:
City	:	ORANGEBURG
State	:	SC
Zip	:	29118-8204
Country	:	US
Telephone Number	:	803-395-4600
Fax Number	:

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

Provider Enumeration Date	:	03/24/2020
Last Update Date	:	06/26/2026

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