Provider Demographics
NPI:1962592410
Name:SHAH, ZAHEER AHMED (MD)
Entity type:Individual
Prefix:
First Name:ZAHEER
Middle Name:AHMED
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 1:2163 E BASELINE RD
Mailing Address - Street 2:STE 101
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1541
Mailing Address - Country:US
Mailing Address - Phone:480-646-8123
Mailing Address - Fax:480-646-8125
Practice Address - Street 1:2163 E BASELINE RD
Practice Address - Street 2:STE 101
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1541
Practice Address - Country:US
Practice Address - Phone:480-646-8123
Practice Address - Fax:480-646-8125
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD 09877207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI11902883Medicare PIN
RI709003947Medicare PIN
RIH05408Medicare UPIN