Doctor Name: | NAMRATA SHAH |
NPI Number: | 1023252665 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | S000-6337-9938 |
Business Practice Address: | 8300 Constitution Ave Ne Pmg At 8300 Constitution Pob Albuquerque, NM - 871107613 |
Business Phone Number: | 5055596100 |
Business Fax Number: | 5055596101 |
Mailing Address: | Po Box 26666, Phs Provider Enrollment ALBUQUERQUE |
State: | NM |
Postal Code: | 871256666 |
Phone Number: | 5059236770 |
Fax Number: | 5059235354 |
NPI Enumeration Date: | 04/27/2009 |
NPI Last Update Date: | 08/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | S000-6337-9938 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |