Provider Demographics
NPI:1194071969
Name:SHAH, APURVA ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:APURVA
Middle Name:ASHOK
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 SUMMER STREET
Mailing Address - Street 2:587
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1216
Mailing Address - Country:US
Mailing Address - Phone:508-363-6470
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMER ST # 587
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-363-6470
Practice Address - Fax:508-363-7470
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA266066207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110114608AMedicaid
OH0135687Medicaid
OHH353210Medicare PIN