Provider Demographics
NPI:1457971715
Name:SHAH, JIGAR K (DO)
Entity Type:Individual
Prefix:
First Name:JIGAR
Middle Name:K
Last Name:SHAH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1425
Mailing Address - Country:US
Mailing Address - Phone:609-581-9100
Mailing Address - Fax:
Practice Address - Street 1:1078 WHITE HORSE AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1425
Practice Address - Country:US
Practice Address - Phone:609-581-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-16
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMTL005724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine