Individual
DR. SANJIV ISHVERLAL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5915 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7565
(352) 565-7006
(786) 220-8715
Mailing address
5915 W GULF TO LAKE HWY, CRYSTAL RIVER, FL 34429-7565
(352) 565-7006
(786) 220-8715
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME69251
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27850
BC
—
05
—
379249800
—
FL
01
—
40434
GRP BC
—
05
—
40434
—
FL
Enumeration date
09/29/2006
Last updated
04/09/2025
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