Provider Demographics
NPI:1588633077
Name:SHAH, DILIP V (MD)
Entity Type:Individual
Prefix:DR
First Name:DILIP
Middle Name:V
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 1ST STREET N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8766
Mailing Address - Country:US
Mailing Address - Phone:205-663-1338
Mailing Address - Fax:205-664-3719
Practice Address - Street 1:1140 1ST ST N
Practice Address - Street 2:SUITE 100
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-8766
Practice Address - Country:US
Practice Address - Phone:205-663-1338
Practice Address - Fax:205-664-3719
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13145207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000057592OtherMEDICARE PROVIDER NUMBER