Individual
DR. PRAKASH D SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY, STE 840, MILWAUKEE, WI 53215-3669
(414) 649-3530
Mailing address
2801 W KINNICKINNIC RIVER PKWY, STE 840, MILWAUKEE, WI 53215-3669
(414) 649-3530
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
32376
WI
207UN0901X
Nuclear Cardiology Physician
32376-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32171700
—
WI
Enumeration date
07/21/2005
Last updated
11/22/2021
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