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NPI Code Detail

MEDICARE: DR. SHEETAL SHAH MD

MEDICARE: DR. SHEETAL 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
1207RN0300XNephrology Physician5333024-1205UT

General Provider Information

NPI Number : 1841271491
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHEETAL SHAH MD
Provider Business Mailing Address
First Line : 2173 E PHEASANT WAY
Second Line :
City : HOLLADAY
State : UT
Zip : 84121-1310
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4252 S HIGHLAND DR STE 200
Second Line :
City : HOLLADAY
State : UT
Zip : 84124-2690
Country : US
Telephone Number : 801-965-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2005
Last Update Date : 12/03/2024

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