Provider Demographics
NPI:1457342131
Name:SHAH, ANAND K (MD)
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:K
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 DUFF AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5469
Mailing Address - Country:US
Mailing Address - Phone:515-239-4400
Mailing Address - Fax:
Practice Address - Street 1:1215 DUFF AVE
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5469
Practice Address - Country:US
Practice Address - Phone:515-239-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-52773207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
940894OtherARAZ GROUP AMERICAS PPO
0103246OtherMEDICA HEALTH PLANS
1023253OtherPREFERRED ONE
197300200OtherMEDICAL ASSISTANCE MA
HP30119OtherHEALTH PARTNERS
125069OtherUCARE
81D52SHOtherBLUE CROSS BLUE SHIELD