Provider Demographics
NPI:1033501408
Name:SHAH, NEIL SANDIP (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:SANDIP
Last Name:SHAH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8431 GARVEY DR
Mailing Address - Street 2:STE 121
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3267
Mailing Address - Country:US
Mailing Address - Phone:517-303-5185
Mailing Address - Fax:
Practice Address - Street 1:8431 GARVEY DR
Practice Address - Street 2:STE 121
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3267
Practice Address - Country:US
Practice Address - Phone:517-303-5185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC22866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist