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Individual

DR. PRATISH H SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2238
(859) 301-4946
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-4000
(859) 301-4001

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
01069939A
IN
2085R0001X
Radiation Oncology Physician
Primary
44467
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0052765
OH
05
201036000
IN
05
7100177250
KY
Enumeration date
07/08/2008
Last updated
07/26/2024
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