Individual
DR. DEEPA S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
401 YOUNG AVE STE 180 FRONT, MOORESTOWN, NJ 08057-3139
(856) 291-8600
(856) 291-8610
Mailing address
301 LIPPINCOTT DR STE 410, MARLTON, NJ 08053-4197
(856) 355-0340
(856) 355-0330
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
240377
NY
207Q00000X
Family Medicine Physician
Primary
25MB10460100
NJ
207Q00000X
Family Medicine Physician
OS9351
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0769282
—
NJ
Enumeration date
11/23/2005
Last updated
10/07/2024
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