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Individual

DR. HARDIK C SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
820 PRUDENTIAL DR STE 304, JACKSONVILLE, FL 32207-8205
(904) 202-3860
(904) 202-3846
Mailing address
PO BOX 746638, ATLANTA, GA 30374-6638
(904) 202-1032
(904) 376-4107

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME97803
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
01058275
IN
208M00000X
Hospitalist Physician
Primary
ME97803
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2778041-00
FL
01
P00469548
RAILROAD MEDICARE
FL
Enumeration date
09/26/2005
Last updated
07/29/2024
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