Provider Demographics
NPI:1194728816
Name:SHAH, NIRMAL K (MD)
Entity type:Individual
Prefix:DR
First Name:NIRMAL
Middle Name:K
Last Name:SHAH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:180 THOMAS JOHNSON DRIVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21704-4550
Mailing Address - Country:US
Mailing Address - Phone:301-631-6877
Mailing Address - Fax:240-566-7820
Practice Address - Street 1:180 THOMAS JOHNSON DR
Practice Address - Street 2:STE 202
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4409
Practice Address - Country:US
Practice Address - Phone:301-631-6877
Practice Address - Fax:240-566-7820
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2022-09-07
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Provider Licenses
StateLicense IDTaxonomies
MDD0057107207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH37023Medicare UPIN