Organization
KESHAV M SHIVA MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KSHAVAMURTHY SHIVASHANKAR MD (OWNER)
(973) 751-7870
Entity
Organization
Contact information
Practice address
140 BELMONT AVE, 102, BELLEVILLE, NJ 07109-1017
(973) 751-7870
(973) 751-7875
Mailing address
140 BELMONT AVE, 102, BELLEVILLE, NJ 07109-1017
(973) 751-7870
(973) 751-7875
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MA4015400000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1973606
—
NJ
Enumeration date
07/05/2012
Last updated
06/17/2013
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