Individual
MITALIE SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
492 MAIN ST, CHATHAM, NJ 07928-2142
(973) 635-2432
(973) 635-6169
Mailing address
PO BOX 416457, BOSTON, MA 02241-6457
(844) 362-1735
(973) 290-7495
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA11065900
NJ
Other
Enumeration date
03/29/2018
Last updated
10/01/2021
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