Individual
NAISHAJ SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
831 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-5243
Mailing address
831 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-5243
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TL30165
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301658
—
SC
01
—
AA20673921
MEDICARE PTAN
SC
Enumeration date
05/01/2007
Last updated
06/24/2010
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