Individual
DR. ASHISH PRABODH SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-5318
(919) 350-7093
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
(877) 498-4490
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
C1-0007922
DE
207RG0100X
Gastroenterology Physician
Primary
2015-00288
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083645477
—
NC
Enumeration date
07/05/2006
Last updated
04/13/2021
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