Individual
DR. SAMIR PRASHANT SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(414) 649-6000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 649-6000
(414) 649-5296
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
52594020
WI
2085R0202X
Diagnostic Radiology Physician
MD60500535
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
52594
WI
2085R0204X
Vascular & Interventional Radiology Physician
MD60500535
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034387
—
WI
05
—
2040623
—
WA
Enumeration date
04/07/2007
Last updated
11/02/2023
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