Provider Demographics
NPI:1578597845
Name:SHAH, NEELOFUR Q (MD)
Entity Type:Individual
Prefix:
First Name:NEELOFUR
Middle Name:Q
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7227 HANOVER PKWY
Mailing Address - Street 2:STE A
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2025
Mailing Address - Country:US
Mailing Address - Phone:888-846-5527
Mailing Address - Fax:607-324-2369
Practice Address - Street 1:4901 TELSA DR
Practice Address - Street 2:SUITE A & B
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4406
Practice Address - Country:US
Practice Address - Phone:301-805-6860
Practice Address - Fax:301-805-0755
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00348182085R0001X
DCMD174082085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD2128955OtherMAMSI
MD238078OtherAMERIGROUP
MD1048186OtherFIRST HEALTH
MD4255520OtherAETNA PPO
MD603327-04OtherCAREFIRST BC/BS
MD037711200Medicaid
MD4578OtherELDER HEALTH
MD5519626OtherCCN
MD7734440OtherCIGNA
MD3465417OtherAETNA HMO
MD2400218 03OtherUNITED HC/AMERICHOICE
MD242714OtherKAISER PERMANENTE
DC668810OtherNATIONAL CAPITOL PPO
DC29020013OtherCAREFIRST BC/BS
MD037711200Medicaid
MD2400218 03OtherUNITED HC/AMERICHOICE
G06596Medicare UPIN