Provider Demographics
NPI:1962792986
Name:SHAH, MANISH (MD)
Entity type:Individual
Prefix:
First Name:MANISH
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 1:508 PRUDENTIAL RD STE 500
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2309
Mailing Address - Country:US
Mailing Address - Phone:855-235-7246
Mailing Address - Fax:
Practice Address - Street 1:410 W LINFIELD TRAPPE RD STE 120
Practice Address - Street 2:
Practice Address - City:LIMERICK
Practice Address - State:PA
Practice Address - Zip Code:19468-4200
Practice Address - Country:US
Practice Address - Phone:855-235-7246
Practice Address - Fax:215-702-7075
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455278208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine