Provider Demographics
NPI:1295036572
Name:SHAH, TANVIR B (MD)
Entity Type:Individual
Prefix:MS
First Name:TANVIR
Middle Name:B
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1210 LEXINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-1949
Mailing Address - Country:US
Mailing Address - Phone:812-948-2400
Mailing Address - Fax:812-948-2400
Practice Address - Street 1:1210 LEXINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1949
Practice Address - Country:US
Practice Address - Phone:812-948-2400
Practice Address - Fax:812-948-2400
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01029328A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology