Individual
DR. NISHANT RAJ SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2894
(401) 793-4102
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
253914
MA
207RC0000X
Cardiovascular Disease Physician
Primary
MD15067
RI
Other
Enumeration date
11/14/2008
Last updated
03/23/2026
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