Provider Demographics
NPI:1285850131
Name:SHAH, UPENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:UPENDRA
Middle Name:
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 1:1 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-1022
Mailing Address - Country:US
Mailing Address - Phone:401-333-5524
Mailing Address - Fax:401-333-5524
Practice Address - Street 1:1 OAK HILL DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-1022
Practice Address - Country:US
Practice Address - Phone:401-333-5524
Practice Address - Fax:401-333-5524
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD04360207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology