Individual
DR. SAMIR SURESH SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3140 PRINCETON PIKE FL 2, LAWRENCEVILLE, NJ 08648-2330
(609) 895-1919
Mailing address
3140 PRINCETON PIKE, 2ND FLOOR, LAWRENCEVILLE, NJ 08648-2330
(609) 895-1919
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
069957
GA
207RC0000X
Cardiovascular Disease Physician
Primary
MD469351
PA
207RI0011X
Interventional Cardiology Physician
069957
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136795A
—
GA
05
—
003136795B
—
GA
05
—
003136795C
—
GA
05
—
003136795D
—
GA
Enumeration date
12/27/2007
Last updated
05/24/2021
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