| Doctor Name: | DR. VIPINCHANDRA K SHAH |
| NPI Number: | 1265454995 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 036053494 |
| Business Practice Address: | 26 Camelot Dr Edwardsville, IL - 620253701 |
| Business Phone Number: | 6186924373 |
| Business Fax Number: | |
| Mailing Address: | 26 Camelot Dr, EDWARDSVILLE |
| State: | IL |
| Postal Code: | 620253701 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 06/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036053494 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |