Individual
DR. MUKHTAR H. SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1148 S. HILLSIDE ST, SUITE 104, WICHITA, KS 67211-4006
(316) 687-0006
(316) 687-0328
Mailing address
1148 S HILLSIDE ST, SUITE 104, WICHITA, KS 67211-4006
(316) 687-0006
(316) 687-0328
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-17352
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
047770
BLUE CROSS BLUE SHIELD
KS
05
—
100089090E
—
KS
01
—
260029156
RR MEDICARE
KS
Enumeration date
07/17/2006
Last updated
01/27/2017
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