Individual
DR. BASHARAT A. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEDICAL PARK BLVD., BRISTOL REGIONAL MEDICAL CENTER, BRISTOL, TN 37620
(423) 282-1480
(423) 928-1353
Mailing address
119 BOONE RIDGE DRIVE, SUITE 201, JOHNSON CITY, TN 37615-1325
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101250967
VA
207R00000X
Internal Medicine Physician
036.116972
IL
207R00000X
Internal Medicine Physician
48226
TN
207R00000X
Internal Medicine Physician
50541-020
WI
208M00000X
Hospitalist Physician
Primary
48226
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34918800
—
WI
01
—
60714
DEAN HEALTH INSURANCE
WI
Enumeration date
02/25/2007
Last updated
10/23/2013
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