Individual
INAGANTI MASTAN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6901 N 72ND ST, SUITE 2244, OMAHA, NE 68122-1709
(402) 572-3535
(402) 572-2688
Mailing address
PO BOX 641850, OMAHA, NE 68164-7850
(402) 572-3535
(402) 572-2688
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
21140
NE
207RH0003X
Hematology & Oncology Physician
33127
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0538751
—
IA
05
—
47077065413
—
NE
01
—
830005301
RAILROAD MEDICARE NORFOLK
NE
01
—
830007286
RAILROAD MEDICARE
NE
01
—
P00325300
RAILROAD MEDICARE
IA
Enumeration date
10/03/2006
Last updated
07/10/2013
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