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Individual

AHSAN ULLAH SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8440 MURANO DEL LAGO DR, ESTERO, FL 34135-8615
(239) 221-5402
(239) 949-5713
Mailing address
PO BOX 102222, ATLANTA, GA 30368-2222
(239) 274-8200

Taxonomy

Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
ME132259
FL
207RX0202X
Medical Oncology Physician
Primary
ME132259
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106697500
FL
Enumeration date
04/15/2014
Last updated
09/02/2022
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