Basic Information
| Provider Information | |||||||||
| NPI: | 1134217425 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MEHUL SHAH MD PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1111 7TH AVE N | ||||||||
| Address2: | #107 | ||||||||
| City: | SAINT PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337051348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278941661 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 7TH AVE N | ||||||||
| Address2: | #107 | ||||||||
| City: | SAINT PETERSBURG | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337051348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7278941661 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHAH | ||||||||
| AuthorizedOfficialFirstName: | MEHUL | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7278941661 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.