Individual
REHAN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6817 SOUTHPOINT PKWY STE 203, JACKSONVILLE, FL 32216-6286
(904) 330-1024
Mailing address
PO BOX 516, OREGON, IL 61061-0516
(214) 272-2774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
071567
GA
207RN0300X
Nephrology Physician
071567
GA
207RN0300X
Nephrology Physician
MD61072096
WA
207RN0300X
Nephrology Physician
Primary
ME127447
FL
207RN0300X
Nephrology Physician
S2503
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2173910
—
WA
Enumeration date
07/26/2007
Last updated
04/22/2024
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