Provider Demographics
NPI:1336552595
Name:SHAH, RUCHA MEHTA (MD)
Entity Type:Individual
Prefix:
First Name:RUCHA
Middle Name:MEHTA
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RUCHA
Other - Middle Name:NILESH
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10210 N 92ND ST STE 202
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4524
Mailing Address - Country:US
Mailing Address - Phone:480-882-7490
Mailing Address - Fax:
Practice Address - Street 1:10210 N 92ND ST STE 202
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4524
Practice Address - Country:US
Practice Address - Phone:480-882-7490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10058785207R00000X
IL125064552207R00000X
AZ60724207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine