Provider Demographics
NPI:1396861431
Name:SHAH, PARUL ASHWIN MEHTA (MD)
Entity Type:Individual
Prefix:DR
First Name:PARUL
Middle Name:ASHWIN MEHTA
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PARUL
Other - Middle Name:ASHWIN
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6378 GRAY SEA WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-7416
Mailing Address - Country:US
Mailing Address - Phone:410-953-0298
Mailing Address - Fax:
Practice Address - Street 1:6378 GRAY SEA WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-7416
Practice Address - Country:US
Practice Address - Phone:410-953-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63085208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics