Individual
DISHA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6400 DUTCHMANS PKWY, SUITE 175, LOUISVILLE, KY 40205-3340
(502) 361-6055
(502) 361-6087
Mailing address
6801 DIXIE HWY, SUITE 130, LOUISVILLE, KY 40258-3913
(502) 361-6055
(502) 361-6087
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
46305
KY
2084N0600X
Clinical Neurophysiology Physician
MD439334
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100250160
—
KY
01
—
P01253581
RAILROAD MEDICARE
KY
Enumeration date
07/13/2009
Last updated
02/04/2014
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