Individual
PRAKASH SHAH
Active
Individual
PRAKASH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31011
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000050781
ANTHEM
KY
01
—
110090936
MEDICARE RAILROAD
KY
01
—
1902803513
NPI
—
05
—
64310113
—
KY
01
—
7493
MEDICARE GROUP
KY
Enumeration date
06/29/2005
Last updated
05/21/2015
Update your record
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