Individual
CHANDRAKANT C SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 WALNUT STREET, BOYERTOWN, PA 19512-1300
(610) 369-0913
(610) 367-8418
Mailing address
23 N WALNUT ST, BOYERTOWN, PA 19512-1467
(610) 369-0913
(610) 369-0917
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD038812L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000406783
HIGHMARK
—
05
—
0007687760006
—
PA
05
—
0015083320001
—
PA
01
—
01227301
CBC
—
Enumeration date
05/23/2006
Last updated
10/10/2013
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