Provider Demographics
NPI:1689967440
Name:SHAH-JADEJA, MANSI (MD)
Entity Type:Individual
Prefix:
First Name:MANSI
Middle Name:
Last Name:SHAH-JADEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:UNC HOSPITALS DEPT OF SURGERY
Mailing Address - Street 2:101 MANNING DR. CB#7050
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7050
Mailing Address - Country:US
Mailing Address - Phone:919-966-4653
Mailing Address - Fax:919-966-7841
Practice Address - Street 1:UNIVERSITY OF KENTUCKY
Practice Address - Street 2:740 SOUTH LIMESTONE, ROOM A301
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536
Practice Address - Country:US
Practice Address - Phone:859-323-5057
Practice Address - Fax:859-257-4682
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-26
Last Update Date:2020-10-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2014-02438208600000X
KY51578208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgery