Individual
SIDDHARTHA S SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 332-2218
Mailing address
60 MAPLE RD, STE 1, WILLIAMSVILLE, NY 14221-2917
(716) 626-5250
(716) 332-2218
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
179451
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010162901
UNIVERA
NY
01
—
000511391004
BLUE CROSS OF WNY
NY
05
—
01339624
—
NY
01
—
040426001814
FIDELIS
NY
01
—
100013189
RAILROAD NEDICARE
NY
01
—
153030BT
PREFERRED CARE
NY
01
—
2307716
INDEPENDENT HEALTH
NY
01
—
2499566
GHI
NY
01
—
5289777
AETNA
NY
Enumeration date
12/22/2005
Last updated
12/06/2013
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