Individual
DR. SIDDHARTH P SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE STREET, 1 FOUNDERS, PHILADELPHIA, PA 19104-2640
(215) 662-2638
Mailing address
3400 SPRUCE STREET, 1 FOUNDERS, PHILADELPHIA, PA 19104-2640
(215) 662-2638
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036118148
IL
207R00000X
Internal Medicine Physician
MD439711
PA
207RN0300X
Nephrology Physician
Primary
MD439711
PA
Other
Enumeration date
06/06/2007
Last updated
04/20/2012
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