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1104043801
PRAKASH SHANTILAL SHAH
MESA, AZ
NPI
1104043801
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: AZ 36825)
Enumeration Date
2007-04-20
Last Update Date
2008-04-29
Business Address
-- PRAKASH SHANTILAL SHAH MD
6644 E BAYWOOD AVE
MESA, AZ 85206-1747
Phone number: 408-981-4391
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Mailing Address
-- PRAKASH SHANTILAL SHAH MD
PO BOX 708850
SANDY, UT 84070-8850
Phone number: 866-869-2395
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