Individual
RAJESH V SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
514 W 2ND ST, BLOOMINGTON, IN 47403-2316
(812) 676-4444
(812) 676-4445
Mailing address
PO BOX 1329, BLOOMINGTON, IN 47402-1329
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01060022A
IN
207RH0000X
Hematology (Internal Medicine) Physician
01060022A
IN
207RH0003X
Hematology & Oncology Physician
Primary
01060022A
IN
207RX0202X
Medical Oncology Physician
01060022A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200506210
—
IN
Enumeration date
07/07/2005
Last updated
12/21/2020
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