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Individual

SIMANT SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE ST, ONE MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-6305
Mailing address
3400 SPRUCE ST, ONE MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-6305

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
1016080
MA
207P00000X
Emergency Medicine Physician
25MA09260000
NJ
207P00000X
Emergency Medicine Physician
MT194587
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0366455
NJ
Enumeration date
04/22/2009
Last updated
07/17/2023
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