Individual
DR. KEVIN J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 GRANITE POINT DR STE 100, WYOMISSING, PA 19610-1992
(610) 378-1344
(610) 378-5169
Mailing address
1 GRANITE POINT DR STE 100, WYOMISSING, PA 19610-1992
(610) 378-1344
(610) 378-5169
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD457586
PA
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
MD457586
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031164500001
—
PA
05
—
1031164500003
—
PA
05
—
1031164500004
—
PA
Enumeration date
06/11/2009
Last updated
06/23/2023
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