Provider Demographics
NPI:1699763391
Name:SHAH, DHIRENKUMAR NAVNITLAL (MD)
Entity type:Individual
Prefix:DR
First Name:DHIRENKUMAR
Middle Name:NAVNITLAL
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 1:300 KEISLER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7083
Mailing Address - Country:US
Mailing Address - Phone:919-233-0059
Mailing Address - Fax:
Practice Address - Street 1:300 KEISLER DR STE 204
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7083
Practice Address - Country:US
Practice Address - Phone:919-233-0059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34732207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
110068402OtherRAILROAD MEDICARE
46398OtherMEDCOST
NC7975405Medicaid
2806804OtherCIGNA HEALTHCARE
2550134OtherUNITED HEALTHCARE
NC75405OtherNC BLUE CROSS BLUE SHIELD
2550134OtherUNITED HEALTHCARE