Provider Demographics
NPI:1386175297
Name:SHAH, PARTH (MD)
Entity type:Individual
Prefix:
First Name:PARTH
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610-1425
Mailing Address - Country:US
Mailing Address - Phone:609-581-9100
Mailing Address - Fax:609-581-7588
Practice Address - Street 1:1078 WHITE HORSE AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610-1425
Practice Address - Country:US
Practice Address - Phone:609-581-9100
Practice Address - Fax:609-581-7588
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD470898207R00000X
NJ25MA11266700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine