Provider Demographics
NPI:1194711358
Name:SHAH, DHAVAL JASVANT (MD)
Entity type:Individual
Prefix:DR
First Name:DHAVAL
Middle Name:JASVANT
Last Name:SHAH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2435 FIRE MESA ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-9009
Mailing Address - Country:US
Mailing Address - Phone:702-968-2437
Mailing Address - Fax:
Practice Address - Street 1:2435 FIRE MESA ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-9009
Practice Address - Country:US
Practice Address - Phone:702-968-2437
Practice Address - Fax:702-479-1796
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2018-09-20
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Provider Licenses
StateLicense IDTaxonomies
NY236694207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCD532ZMedicare PIN