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Individual

DR. CHETAN CHANDULAL SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.B.B.S

Contact information

Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-8426
(352) 265-0291
(352) 265-0279
Mailing address
PO BOX 100374, GAINESVILLE, FL 32610-0374
(352) 265-0291
(352) 265-0279

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
E-5677
AR
2085P0229X
Pediatric Radiology Physician
C10010212
DE
2085P0229X
Pediatric Radiology Physician
E-5677
AR
2085P0229X
Pediatric Radiology Physician
Primary
ME113302
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006569400
FL
05
170947001
AR
Enumeration date
06/21/2007
Last updated
01/20/2022
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