Individual
KAUSTAV SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 SPRUCE ST FL MALONEY5, PHILADELPHIA, PA 19104-4238
(215) 662-3797
Mailing address
3400 SPRUCE ST FL MALONEY5, PHILADELPHIA, PA 19104-4238
(215) 662-3797
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
484199
PA
Other
Enumeration date
03/27/2021
Last updated
09/18/2024
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