Provider Demographics
NPI:1194773770
Name:SHAH, GEETA MOHLA (MD)
Entity type:Individual
Prefix:DR
First Name:GEETA
Middle Name:MOHLA
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5471 WISCONSIN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-3546
Mailing Address - Country:US
Mailing Address - Phone:301-798-9699
Mailing Address - Fax:240-802-2993
Practice Address - Street 1:5471 WISCONSIN AVE STE 200
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-3546
Practice Address - Country:US
Practice Address - Phone:301-798-9699
Practice Address - Fax:240-802-2993
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064140207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H92722Medicare UPIN