Individual
RUSSELL J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2628 W CHARLESTON BLVD, LAS VEGAS, NV 89102-2176
(702) 644-0500
(702) 641-4600
Mailing address
10624 S EASTERN AVE STE A-425, HENDERSON, NV 89052-2982
(702) 644-0500
(702) 641-4600
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
10954
NV
2084N0400X
Neurology Physician
A73247
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0090830
—
CA
Enumeration date
10/25/2006
Last updated
02/26/2008
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