Provider Demographics
NPI:1457558363
Name:SHAH, PARUL P (PA-C)
Entity Type:Individual
Prefix:MS
First Name:PARUL
Middle Name:P
Last Name:SHAH
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:16049 FONTANA ST UNIT 505
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8485
Mailing Address - Country:US
Mailing Address - Phone:570-431-0772
Mailing Address - Fax:913-489-9080
Practice Address - Street 1:7127 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66212-2245
Practice Address - Country:US
Practice Address - Phone:913-489-9070
Practice Address - Fax:913-489-9080
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2020-06-10
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Provider Licenses
StateLicense IDTaxonomies
MO2016009737363A00000X
PAMA052791363A00000X
KS1501751363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant