Provider Demographics
NPI:1508061623
Name:SHAH, SHILPAN H (MD)
Entity Type:Individual
Prefix:
First Name:SHILPAN
Middle Name:H
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:331 3RD AVE
Mailing Address - Street 2:9 D
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-6331
Mailing Address - Country:US
Mailing Address - Phone:732-263-1120
Mailing Address - Fax:732-923-6536
Practice Address - Street 1:331 3RD AVE
Practice Address - Street 2:9 D
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6331
Practice Address - Country:US
Practice Address - Phone:732-263-1120
Practice Address - Fax:732-923-6536
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08262300207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine