MEDICARE: BHARAT J SHAH MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	R3A49	MO
2	207RC0000X	Cardiovascular Disease Physician	036064312	IL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1993V3831	OTHER		GHP/CMR
2	4040666	OTHER		AETNA
3	1475257	OTHER		CIGNA
4	103383	OTHER		HLNK
5	27888	OTHER	MO	MOBS/BLCHOICE
6	42760V30946	OTHER		HLTHPART
7	060067911	OTHER	IL	ILRRMCR
8	2509028	OTHER		UHC
9	000000013077	OTHER		ESSENCE
10	A29082	OTHER		MERCY
11	060015451	OTHER	MO	MORRMCR
12	10095V8816	OTHER		HCUSA
13	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1811980717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BHARAT J SHAH MD

Provider Business Mailing Address
First Line	:	11125 DUNN RD
Second Line	:	SUITE 204
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-839-5522
Fax Number	:	314-839-5351

Provider Business Practice Location Address
First Line	:	11125 DUNN RD
Second Line	:	SUITE 204
City	:	SAINT LOUIS
State	:	MO
Zip	:	63136-6132
Country	:	US
Telephone Number	:	314-839-5522
Fax Number	:	314-839-5351

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	02/25/2016

11125 DUNN RD , STE 402
SAINT LOUIS, MO
63136-6132

Practice Phone: 314-741-3400
Practice Fax: 314-741-4357

11125 DUNN RD , STE 204
SAINT LOUIS, MO
63136-6132