Individual
KETAN VIKRAMBHAI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 HIGHLAND AVE, HANOVER, PA 17331-2297
(717) 316-3711
Mailing address
300 HIGHLAND AVE, HANOVER, PA 17331-2297
(717) 316-3711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD449148
PA
208M00000X
Hospitalist Physician
MD449148
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102836582
—
PA
Enumeration date
04/19/2010
Last updated
12/12/2020
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