Provider Demographics
NPI:1285998609
Name:SHAH, NIHAR U (MD)
Entity type:Individual
Prefix:DR
First Name:NIHAR
Middle Name:U
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:510-204-8120
Mailing Address - Fax:510-506-7721
Practice Address - Street 1:2850 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705
Practice Address - Country:US
Practice Address - Phone:510-204-8120
Practice Address - Fax:510-506-7721
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133210207RI0008X
CA989517207RG0100X
KY48939207RI0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207RI0008XAllopathic & Osteopathic PhysiciansInternal MedicineHepatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA133210OtherSTATE MEDICAL LICENSE
WA0296704OtherLABOR AND INDUSTRY
WA0296704OtherLABOR AND INDUSTRY