Individual
PANKAJKUMAR C SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 W 18TH ST, HOPKINSVILLE, KY 42240-1965
(270) 887-0100
(270) 887-0342
Mailing address
PO BOX 55, HOPKINSVILLE, KY 42241-0055
(270) 887-0100
(270) 887-0342
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
40815
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000526170
ANTHEM BCBS
KY
05
—
7100016400
—
KY
Enumeration date
05/31/2007
Last updated
12/11/2009
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