Individual
NEIL ASHVIN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 LONG LAKE RD STE 150, NEW BRIGHTON, MN 55112-6414
(612) 213-2370
(612) 524-5571
Mailing address
900 LONG LAKE RD STE 150, NEW BRIGHTON, MN 55112-6414
(612) 213-2370
(612) 213-2370
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
50969
MN
207ND0101X
MOHS-Micrographic Surgery Physician
50969
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
01
—
P00813436
RAILROAD MEDICARE
MN
Enumeration date
07/27/2007
Last updated
06/06/2023
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