Provider Demographics
NPI:1174780118
Name:M.H. SHAH, M.D.
Entity type:Organization
Organization Name:M.H. SHAH, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:M.
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:316-687-0006
Mailing Address - Street 1:1148 S HILLSIDE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67211-4005
Mailing Address - Country:US
Mailing Address - Phone:316-687-0006
Mailing Address - Fax:316-687-0328
Practice Address - Street 1:1148 S HILLSIDE ST STE 104
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67211-4005
Practice Address - Country:US
Practice Address - Phone:316-687-0006
Practice Address - Fax:316-687-0328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-173522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS047770OtherBC/BS OF KS.
KS100088090EMedicaid
KS047770Medicare PIN
KSB69419Medicare UPIN