Provider Demographics
NPI:1689683914
Name:SHAH, SONA MAHENDRA (MD)
Entity Type:Individual
Prefix:
First Name:SONA
Middle Name:MAHENDRA
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 1:9035 WADSWORTH PKWY STE 3000
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-8628
Mailing Address - Country:US
Mailing Address - Phone:303-422-7677
Mailing Address - Fax:303-422-6029
Practice Address - Street 1:9035 WADSWORTH PKWY STE 3000
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-8628
Practice Address - Country:US
Practice Address - Phone:303-422-7677
Practice Address - Fax:303-422-6029
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO37219208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01372192Medicaid
CO01372192Medicaid