Provider Demographics
NPI:1174813208
Name:SHAH, CHIRAG A (MD)
Entity type:Individual
Prefix:DR
First Name:CHIRAG
Middle Name:A
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:333 CEDAR ST
Mailing Address - Street 2:P.O. BOX 208030
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-3206
Mailing Address - Country:US
Mailing Address - Phone:203-573-7354
Mailing Address - Fax:203-573-6707
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:YALE-NEW HAVEN HOSPITAL
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-573-7354
Practice Address - Fax:203-573-6707
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CT60432207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program