Individual
HEATHER RAKESH SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1107 14TH AVE SE STE 200, DECATUR, AL 35601-3354
(256) 705-4224
(256) 705-4135
Mailing address
PO BOX 18428, HUNTSVILLE, AL 35804-8428
(256) 705-4224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
26421
AL
207RH0003X
Hematology & Oncology Physician
Primary
26421
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009936592
—
AL
01
—
051557488
MEDICARE OF ALABAMA
AL
05
—
117675
—
AL
01
—
511-04421
BLUE CROSS OF ALABAMA
AL
Enumeration date
05/16/2006
Last updated
01/27/2023
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