Provider Demographics
NPI:1437189404
Name:HETAL C. SHAH, M.D., P.C.
Entity Type:Organization
Organization Name:HETAL C. SHAH, M.D., P.C.
Other - Org Name:ARIZONA WOMEN'S SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:HETAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-430-0940
Mailing Address - Street 1:4700 N 51ST AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85031-1237
Mailing Address - Country:US
Mailing Address - Phone:623-846-7597
Mailing Address - Fax:623-846-1826
Practice Address - Street 1:4700 N 51ST AVE STE 5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85031-1237
Practice Address - Country:US
Practice Address - Phone:623-846-7597
Practice Address - Fax:623-846-1826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ81268OtherMEDICARE PTAN