Provider Demographics
NPI:1235242934
Name:SHAH, RAHUL V (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:V
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 1:352 S DELSEA DR STE C
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-5306
Mailing Address - Country:US
Mailing Address - Phone:856-690-1616
Mailing Address - Fax:
Practice Address - Street 1:352 S DELSEA DR STE C
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5306
Practice Address - Country:US
Practice Address - Phone:856-690-1616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08542100207X00000X, 207XS0117X
NHLT 2765207X00000X
FLME96545207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30208276Medicaid
FL56465OtherBCBS
NH000906401Medicare PIN
NH30208276Medicaid
FLAC433ZMedicare PIN
FLP00399347Medicare PIN
NHP00684100Medicare PIN