Provider Demographics
NPI:1710192489
Name:SHAH, DARSHIL JATINBHAI (MD)
Entity Type:Individual
Prefix:
First Name:DARSHIL
Middle Name:JATINBHAI
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:PO BOX 6423
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85246-6423
Mailing Address - Country:US
Mailing Address - Phone:623-312-3020
Mailing Address - Fax:623-487-6747
Practice Address - Street 1:13055 W MCDOWELL RD STE G112
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-6459
Practice Address - Country:US
Practice Address - Phone:623-312-3020
Practice Address - Fax:623-487-6747
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53508207RH0003X, 207RH0003X
KY46898207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ258494Medicaid