Individual
DR. NIRAV G. SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-8141
(410) 328-0177
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8141
(410) 328-0177
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D63242
MD
207RP1001X
Pulmonary Disease Physician
D63242
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821011370
—
DE
05
—
417538700
—
MD
01
—
895154-02 & 03
BLUE CROSS/BLUE SHIELD
MD
01
—
S062-0354
BLUE CROSS/BLUE SHIELD - REGIONAL
MD
Enumeration date
07/25/2006
Last updated
09/24/2012
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