Basic Information
| Provider Information | |||||||||
| NPI: | 1225267297 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAH | ||||||||
| FirstName: | RACHIT | ||||||||
| MiddleName: | MUKESHBHAI | ||||||||
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| Credential: | MBBS, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6633 FOREST AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346532612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2772486117 | ||||||||
| FaxNumber: | 7277240425 | ||||||||
| Practice Location | |||||||||
| Address1: | 6633 FOREST AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | NEW PORT RICHEY | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346532612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2772486117 | ||||||||
| FaxNumber: | 7277240425 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2009 | ||||||||
| LastUpdateDate: | 08/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125.055761 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 390200000X | VA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207RC0000X | 35104 | AL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No ID Information.