Individual
SHAN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-2980
(662) 772-2960
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27813
MS
207R00000X
Internal Medicine Physician
61053
TN
207R00000X
Internal Medicine Physician
E-14096
AR
Other
Enumeration date
08/23/2017
Last updated
04/13/2021
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