Provider Demographics
NPI:1225066491
Name:SHAH, UTPAL SURESH (MD)
Entity Type:Individual
Prefix:DR
First Name:UTPAL
Middle Name:SURESH
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300B PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1411
Mailing Address - Country:US
Mailing Address - Phone:609-448-7300
Mailing Address - Fax:609-448-8022
Practice Address - Street 1:300B PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:SUITE #201
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1411
Practice Address - Country:US
Practice Address - Phone:609-448-7300
Practice Address - Fax:609-448-8022
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA0727682080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine