Provider Demographics
NPI:1427119247
Name:SHAH, MEHUL N (MD)
Entity type:Individual
Prefix:DR
First Name:MEHUL
Middle Name:N
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:128 HARTSHORN DR
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1613
Mailing Address - Country:US
Mailing Address - Phone:973-378-2121
Mailing Address - Fax:973-467-0150
Practice Address - Street 1:116 MILLBURN AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041
Practice Address - Country:US
Practice Address - Phone:973-378-2121
Practice Address - Fax:973-467-0150
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA04839600207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4590007Medicaid
E75159Medicare UPIN