Provider Demographics
NPI:1912002452
Name:SHAH ASSOCIATES MD LLC
Entity Type:Organization
Organization Name:SHAH ASSOCIATES MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-373-7900
Mailing Address - Street 1:24035 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20636-4871
Mailing Address - Country:US
Mailing Address - Phone:301-373-7900
Mailing Address - Fax:301-373-6900
Practice Address - Street 1:24035 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:MD
Practice Address - Zip Code:20636-4871
Practice Address - Country:US
Practice Address - Phone:301-373-7900
Practice Address - Fax:301-373-6900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD3558OtherBCBS DC FED
MD354ASHOtherBCBS CAREFIRST POS SPEC
MD354ASHOtherBCBS CAREFIRST TOWSON SPE
MD12998OtherAETNA HMO SPECIALIST
MD3558OtherBCBS CAREFIRST
MDH888SHOtherBCSB CAREFIRST TOWSON
MD5327523OtherAETNA ALL OTHERS
MDH888SHOtherBCBS CAREFIRST POS
MDH888SHOtherBCBS MD
MD8317462OtherAETNA ALL OTHERS SPE
MD354ASHOtherBCBS MD SPECIALIST
MD488609OtherAETNA HMO
MDH888SHOtherBCBS OF ILLINOIS
MDCG9362OtherMEDICARE RAILROAD
MD354ASHOtherBCBS CAREFIRST POS SPEC
MD3558OtherBCBS DC FED