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Individual

DR. MANILAL B SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2211 MAYFAIR DR, SUITE 202, OWENSBORO, KY 42301-4568
(270) 688-4480
(270) 688-4489
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
22408
KY
2080A0000X
Pediatric Adolescent Medicine Physician
22408
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64224082
KY
Enumeration date
09/20/2006
Last updated
06/19/2014
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