Provider Demographics
NPI:1871639450
Name:SHAH, MALVIKA S (MD)
Entity Type:Individual
Prefix:
First Name:MALVIKA
Middle Name:S
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1501 PRESIDENTIAL WAY STE 12
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-1852
Mailing Address - Country:US
Mailing Address - Phone:561-471-9484
Mailing Address - Fax:561-471-9555
Practice Address - Street 1:1501 PRESIDENTIAL WAY
Practice Address - Street 2:12
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-1852
Practice Address - Country:US
Practice Address - Phone:561-471-9484
Practice Address - Fax:561-471-9555
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME34774207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology