Individual
MINDY S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6737 W WASHINGTON ST STE 2150, WEST ALLIS, WI 53214-5649
(608) 224-9371
Mailing address
50 S B B KING BLVD STE 100, MEMPHIS, TN 38103-2626
(866) 949-0108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
231472
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
20072
ND
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
231472
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
72725
MN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
231472
NY
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
63930
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02748043
—
NY
05
—
1461173
—
ND
Enumeration date
06/03/2006
Last updated
06/18/2025
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