Organization
DR SHAH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DINESH H SHAH MD (OWNER)
(270) 247-2100
Entity
Organization
Contact information
Practice address
225 W WATER ST, MAYFIELD, KY 42066-2240
(270) 247-2100
(270) 247-2113
Mailing address
225 W WATER ST, MAYFIELD, KY 42066-2240
(270) 247-2100
(270) 247-2113
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26092
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000341370
BCBS
KY
01
—
4219055
AETNA
KY
05
—
64260920
—
KY
Enumeration date
02/05/2007
Last updated
08/22/2020
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