Provider Demographics
NPI:1629462155
Name:SHAH, SUNNY (MD)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:
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 1:401 W 2ND ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-5345
Mailing Address - Country:US
Mailing Address - Phone:775-784-4917
Mailing Address - Fax:775-784-1428
Practice Address - Street 1:401 W 2ND ST
Practice Address - Street 2:SUITE 215
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-5345
Practice Address - Country:US
Practice Address - Phone:775-784-4917
Practice Address - Fax:775-784-1428
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program