Provider Demographics
NPI:1013999895
Name:SHAH, RAVI C (MD)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:C
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9235 CROWN CREST BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8880
Mailing Address - Country:US
Mailing Address - Phone:303-840-5051
Mailing Address - Fax:303-840-5058
Practice Address - Street 1:9235 CROWN CREST BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8880
Practice Address - Country:US
Practice Address - Phone:303-840-5051
Practice Address - Fax:303-840-5058
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2014-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO435392084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO803524Medicare ID - Type UnspecifiedINDIVIDUEL
COI42906Medicare UPIN
CO803523Medicare ID - Type UnspecifiedGROUP