Individual
CARMELITA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
345 1ST ST S, WINTHROP, IA 50682-0130
(319) 935-3343
(319) 935-3331
Mailing address
950 67TH ST UNIT 315, WEST DES MOINES, IA 50266-2425
(515) 771-0668
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
23149
IA
208D00000X
General Practice Physician
Primary
23149
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0218313
—
IA
Enumeration date
01/17/2006
Last updated
06/10/2019
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