Provider Demographics
NPI:1053109355
Name:SHAH, HARSH MANISHBHAI (MBBS)
Entity type:Individual
Prefix:MR
First Name:HARSH
Middle Name:MANISHBHAI
Last Name:SHAH
Suffix:
Gender:
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 REDMOND ROAD
Mailing Address - Street 2:ROME, GA 30165
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165
Mailing Address - Country:US
Mailing Address - Phone:706-291-0291
Mailing Address - Fax:
Practice Address - Street 1:501 REDMOND ROAD
Practice Address - Street 2:ROME, GA 30165
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165
Practice Address - Country:US
Practice Address - Phone:706-291-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program