| Sanjay J. Shah M.d. P.c. | |
|
5523 W Lariat Ln Phoenix AZ 85083-1231 | |
| (602) 842-7555 | |
| (602) 753-0183 |
| Full Name | Sanjay J. Shah M.d. P.c. |
|---|---|
| Speciality | General Practice |
| Location | 5523 W Lariat Ln, Phoenix, Arizona |
| Authorized Official Name and Position | Sanjay Shah (PRESIDENT) |
| Authorized Official Contact | 6028427555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sanjay J. Shah M.d. P.c. 5523 W Lariat Ln Phoenix AZ 85083-1231 Ph: (602) 842-7555 | Sanjay J. Shah M.d. P.c. 5523 W Lariat Ln Phoenix AZ 85083-1231 Ph: (602) 842-7555 |
| NPI Number | 1114105434 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 10/22/2019 |
| Medicare PECOS PAC ID | 7810029295 |
|---|---|
| Medicare Enrollment ID | O20100721000017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114105434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Sanjay J Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952315988 PECOS PAC ID: 9032166087 Enrollment ID: I20050401000731 |
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