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Individual
MR. VIDATH K SHAH
Active
Individual
MR. VIDATH K SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501013380
STATE OF MICHIGAN
MI
Enumeration date
10/19/2009
Last updated
10/19/2009
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