Individual
DR. JAYESH B SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E MOUNTAIN BLVD, WILKES BARRE, PA 18711-0027
(570) 808-8653
(570) 808-8658
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
17410
WV
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD042382E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007020000
—
WV
Enumeration date
04/10/2006
Last updated
06/20/2019
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