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Individual
MR. HETAL S SHAH
Active
Individual
MR. HETAL S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07503100
NJ
207Q00000X
Family Medicine Physician
MA075031
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0045047
—
NJ
01
—
240537
AMERIGROUP
NJ
01
—
7876554
AETNA
NJ
Enumeration date
07/03/2006
Last updated
11/25/2014
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