Individual
JAY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11327 N DAISY RD, DUNLAP, IL 61525-9436
(307) 277-2487
Mailing address
11327 N DAISY RD, DUNLAP, IL 61525-9436
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
70616-20
WI
Other
Enumeration date
07/04/2014
Last updated
07/17/2020
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