Provider Demographics
NPI:1326036559
Name:SHAH, RAJIV R (DO)
Entity Type:Individual
Prefix:
First Name:RAJIV
Middle Name:R
Last Name:SHAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2950 S MARYLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-2257
Mailing Address - Country:US
Mailing Address - Phone:702-732-6000
Mailing Address - Fax:702-732-6071
Practice Address - Street 1:2950 S MARYLAND PKWY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-2257
Practice Address - Country:US
Practice Address - Phone:702-732-6000
Practice Address - Fax:702-732-6071
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS95382085R0202X
NV12762085R0202X
NY239607-012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology