Individual
MITAL SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4405
(215) 662-2638
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4405
(215) 662-2638
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
25MA11359900
NJ
207RN0300X
Nephrology Physician
Primary
MD463824
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2015
Last updated
04/09/2024
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