Provider Demographics
NPI:1710061270
Name:SHAH, SHILPA NARENDRA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHILPA
Middle Name:NARENDRA
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 1:2713 DANTZLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9005
Mailing Address - Country:US
Mailing Address - Phone:843-764-1722
Mailing Address - Fax:843-764-1788
Practice Address - Street 1:2713 DANTZLER DRIVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9005
Practice Address - Country:US
Practice Address - Phone:843-764-1722
Practice Address - Fax:843-764-1788
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL29166208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics