Provider Demographics
NPI:1225297856
Name:SHAH, VARSHA V (MD)
Entity Type:Individual
Prefix:DR
First Name:VARSHA
Middle Name:V
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4425 N PORT WASHINGTON RD
Mailing Address - Street 2:ATTN: CSMCP CLINIC CREDENTIALING
Mailing Address - City:GLENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:53212-1082
Mailing Address - Country:US
Mailing Address - Phone:414-298-7250
Mailing Address - Fax:414-298-7251
Practice Address - Street 1:2350 N LAKE DR
Practice Address - Street 2:#100
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4528
Practice Address - Country:US
Practice Address - Phone:414-298-7250
Practice Address - Fax:414-298-7251
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2012-06-12
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Provider Licenses
StateLicense IDTaxonomies
NY234633207R00000X, 207RH0003X
WI53353207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine