Individual
MEENAXI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5900 S LAKE DRIVE, CUDAHY, WI 53110-3171
(414) 489-4190
(414) 489-4105
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 489-4190
(414) 489-4015
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32914-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31953400
—
WI
Enumeration date
08/28/2006
Last updated
11/03/2023
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