Provider Demographics
NPI:1255694436
Name:SHAH, KEHKESHAN (MD)
Entity Type:Individual
Prefix:
First Name:KEHKESHAN
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3937 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-3222
Mailing Address - Country:US
Mailing Address - Phone:412-622-7343
Mailing Address - Fax:412-621-8235
Practice Address - Street 1:816 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4915
Practice Address - Country:US
Practice Address - Phone:412-321-4001
Practice Address - Fax:412-321-4063
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD455506207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine