Provider Demographics
NPI:1285937714
Name:SHAH, MADHUKAR N (MD)
Entity type:Individual
Prefix:DR
First Name:MADHUKAR
Middle Name:N
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:207 ASBURY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1839
Mailing Address - Country:US
Mailing Address - Phone:978-468-3064
Mailing Address - Fax:978-468-3064
Practice Address - Street 1:207 ASBURY ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1839
Practice Address - Country:US
Practice Address - Phone:978-468-3064
Practice Address - Fax:978-468-3064
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
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Provider Licenses
StateLicense IDTaxonomies
MA34062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB97363Medicare UPIN