Individual
DR. PIYUSH J SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2814 THEATER AVE, PEDIATRIC MEDICAL GROUP INC, HUNTINGTON, IN 46750-7978
(260) 356-3611
(260) 358-4263
Mailing address
2814 THEATER AVE, PEDIATRIC MEDICAL GROUP INC, HUNTINGTON, IN 46750-7978
(260) 356-3611
(260) 358-4263
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01026608A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01026608A
LICENSE
IN
05
—
100144900A
—
IN
Enumeration date
04/17/2006
Last updated
02/20/2013
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