Individual
DR. MANOJ P SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14055 SEAWAY RD, GULFPORT, MS 39503
(228) 868-5555
(228) 574-2002
Mailing address
14055 SEAWAY RD, GULFPORT, MS 39503
(228) 868-5555
(228) 574-2002
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
17037
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00123304
—
MS
Enumeration date
08/30/2006
Last updated
09/07/2012
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