Individual
DR. RAJIV S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 261-4493
(315) 261-4498
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1799
(315) 265-3300
(315) 261-4498
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
168997
NY
207RG0100X
Gastroenterology Physician
Primary
168997
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01061641
—
NY
01
—
110022828
RAILROAD MEDICARE
NY
Enumeration date
08/18/2006
Last updated
03/11/2020
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