Individual
AMIT J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 CALVARY CHURCH RD, FESTUS, MO 63028-4125
(636) 933-2900
Mailing address
1500 CALVARY CHURCH RD, FESTUS, MO 63028-4125
(636) 933-2900
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
2013038956
MO
207R00000X
Internal Medicine Physician
2013038956
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134246770
—
MO
Enumeration date
03/26/2007
Last updated
03/02/2016
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