Individual
ASHOK CHAMPAKLAL SHAH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3808 S HOPKINS AVE, TITUSVILLE, FL 32780-5753
(321) 268-2005
(321) 264-2235
Mailing address
PO BOX 1980, MELBOURNE, FL 32902-1980
(321) 268-2005
(321) 264-2235
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME67131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26294
BCBS
FL
Enumeration date
09/06/2005
Last updated
07/08/2007
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