Provider Demographics
NPI:1386895688
Name:SHAH, REHAN (MD)
Entity type:Individual
Prefix:
First Name:REHAN
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 1:2239 WHITEHORSE MERCERVILLE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-2656
Mailing Address - Country:US
Mailing Address - Phone:609-838-9700
Mailing Address - Fax:609-838-9702
Practice Address - Street 1:2239 WHITEHORSE MERCERVILLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-2656
Practice Address - Country:US
Practice Address - Phone:609-838-9700
Practice Address - Fax:609-838-9702
Is Sole Proprietor?:No
Enumeration Date:2008-10-05
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NJ25MA09274400207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program