Dr Shah Clinic
Organization Active NPI Internal Medicine Physician · Mayfield, KY
NPI 1124167333 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1124167333
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 26092 (KY)
- Legal business name
- DR SHAH CLINIC
- Practice address
- 225 W Water St
Mayfield, KY 42066-2240 - Phone
- (270) 247-2100
- Fax
- (270) 247-2113
- NPI assigned
- Feb 5, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Dinesh H Shah, MD
- Title
- Owner
- Phone
- (270) 247-2100
National Provider Directory
Locations
225 W Water St
Mayfield, KY 42066
Phone (270) 247-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 26092 | KY | Yes |
Addresses
Primary practice location
225 W Water St
Mayfield, KY 42066-2240
Mailing address
225 W Water St
Mayfield, KY 42066-2240
Phone (270) 247-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4219055 | Other | KY | AETNA |
| 64260920 | Medicaid | KY | |
| 000000341370 | Other | KY | BCBS |
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All providers in Mayfield, KY · Internal Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.