Individual
DR. SANJAY SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1218 WALTER REED RD, FAYETTEVILLE, NC 28304-4440
(910) 323-1671
(910) 323-9656
Mailing address
ATTN. MANAGED CARE PLANNING, PO BOX 40908, FAYETTEVILLE, NC 28309
(910) 615-6949
(910) 615-9761
Taxonomy
Speciality
Code
Description
License number
State
207LH0002X
Hospice and Palliative Medicine (Anesthesiology) Physician
9801484
NC
207R00000X
Internal Medicine Physician
Primary
9801484
NC
207RN0300X
Nephrology Physician
9801484
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390007497
MEDICARE RAILROAD
NC
05
—
8911560
—
NC
Enumeration date
07/03/2006
Last updated
06/20/2019
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