Individual
DR. MRUNALINI B SHAH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1130 LOUISIANA AVE, SHREVEPORT, LA 71101-3908
(318) 678-4472
Mailing address
PO BOX 3591, SHREVEPORT, LA 71133-3591
(318) 678-4472
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
L40598R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1308455
—
LA
Enumeration date
03/17/2006
Last updated
07/08/2007
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