Individual
GAUTAM MOTLLAL SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10192 W. COGGINS DRIVE, SUN CITY, AZ 85351-3405
(623) 974-2434
(623) 974-4925
Mailing address
10192 W. COGGINS DRIVE, SUN CITY, AZ 85351-3405
(623) 974-2434
(623) 974-4925
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10116
AZ
207RP1001X
Pulmonary Disease Physician
Primary
10116
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208745
—
AZ
Enumeration date
05/19/2006
Last updated
03/03/2011
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