Provider Demographics
NPI:1194179077
Name:SHAH, MANAN JAYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:MANAN
Middle Name:JAYANT
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 FORBES AVE APT 1332
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3177
Mailing Address - Country:US
Mailing Address - Phone:973-978-4326
Mailing Address - Fax:
Practice Address - Street 1:200 LOTHROP ST STE B400
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2536
Practice Address - Country:US
Practice Address - Phone:412-647-3685
Practice Address - Fax:412-647-8447
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD480761207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery