Provider Demographics
NPI:1295960730
Name:CHIRAG SHAH, DO, LLC
Entity type:Organization
Organization Name:CHIRAG SHAH, DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:813-335-9330
Mailing Address - Street 1:8870 N HIMES AVE
Mailing Address - Street 2:SUITE # 258
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1627
Mailing Address - Country:US
Mailing Address - Phone:813-335-9330
Mailing Address - Fax:
Practice Address - Street 1:8870 N HIMES AVE
Practice Address - Street 2:SUITE # 258
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1627
Practice Address - Country:US
Practice Address - Phone:813-335-9330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty