Individual
DR. MODASER - SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
530 E 34TH ST., JOPLIN, MO 64803-2526
(417) 347-7540
(417) 347-7549
Mailing address
530 E 34TH ST., JOPLIN, MO 64803-2526
(417) 347-7540
(417) 347-7549
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R7170
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS10290A005
BCBS
MO
Enumeration date
10/04/2006
Last updated
07/08/2007
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