Provider Demographics
NPI:1265688105
Name:SHAH, RITA GHUTAI (MD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:GHUTAI
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GHUTAI
Other - Middle Name:RITA
Other - Last Name:MAHIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:701 SHADOW LN
Mailing Address - Street 2:STE 200
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4195
Mailing Address - Country:US
Mailing Address - Phone:702-383-2691
Mailing Address - Fax:702-388-4114
Practice Address - Street 1:701 SHADOW LN
Practice Address - Street 2:STE 200
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4195
Practice Address - Country:US
Practice Address - Phone:702-383-2691
Practice Address - Fax:702-388-4114
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15366208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1265688105Medicaid