Individual
DR. SYED AHMED SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1007 ML KING DR, SUITE 1, CENTRALIA, IL 62801-3003
(618) 533-9577
(618) 533-9588
Mailing address
PO BOX 431, CENTRALIA, IL 62801-9107
(618) 533-9577
(618) 533-9588
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036097235
IL
Other
Enumeration date
08/03/2005
Last updated
09/09/2021
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