Individual
KINJAL SUNILKUMAR SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1265 UNION AVE, MEMPHIS, TN 38104-3415
(901) 516-7182
(901) 276-5474
Mailing address
930 MADISON AVENUE SUITE 500, MEMPHIS, TN 38163-0001
(901) 516-7182
(901) 276-5474
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
56303
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00031784
—
MS
01
—
6133336
BCBS
TN
05
—
Q032935
—
TN
Enumeration date
04/06/2012
Last updated
03/28/2018
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