Provider Demographics
NPI:1881893741
Name:SHAH, SAMIR RAMESHCHANDRA (MD)
Entity type:Individual
Prefix:DR
First Name:SAMIR
Middle Name:RAMESHCHANDRA
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 S DADELAND BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-2866
Mailing Address - Country:US
Mailing Address - Phone:305-468-4185
Mailing Address - Fax:305-596-3073
Practice Address - Street 1:5803 NW 151ST ST STE 105
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2473
Practice Address - Country:US
Practice Address - Phone:305-596-3080
Practice Address - Fax:305-596-3073
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC38018208600000X, 208C00000X
FLME140999208D00000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice