Provider Demographics
NPI:1366556854
Name:SHAH, RAJIV RAMANIK (MD)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:RAMANIK
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6363 FRANCE AVE S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2129
Mailing Address - Country:US
Mailing Address - Phone:952-920-2070
Mailing Address - Fax:952-920-7444
Practice Address - Street 1:6363 FRANCE AVE S
Practice Address - Street 2:SUITE 400
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2129
Practice Address - Country:US
Practice Address - Phone:952-920-2070
Practice Address - Fax:952-920-7444
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-12-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN44606207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1778775OtherFHP
WI34310900OtherWISCONSIN MA
MNHP37176OtherHEALTHPARTNERS
MN3180156OtherMEDICA PRIMARY
MN927511033032OtherPREFERREDONE
MNP00255836OtherRAILROAD MEDICARE
MN3100286OtherPHP
MN330G5SHOtherBCBS
MNHP37176OtherHEALTHPARTNERS
MN3180156OtherMEDICA PRIMARY