Individual
DR. CHANDRAVADAN I SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 2ND ST, OHI INC, LAKEWOOD, NJ 08701-3324
(732) 363-6655
(732) 363-6656
Mailing address
101 2ND ST, LAKEWOOD, NJ 08701-3324
(732) 363-6655
(732) 363-6656
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA04906800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264303
—
NJ
Enumeration date
03/23/2006
Last updated
03/07/2023
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