Shah, Atul Mukutbhai

Shah, Atul Mukutbhai is an sole proprietor health care provider with primary practice located at 6310 Beach Blvd , Jacksonville FL 32216-2708. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Shah, Atul Mukutbhai can be contacted via phone (904) 725-6463.

Contact Information

Primary practice address
6310 Beach Blvd Jacksonville FL 32216-2708
Phone: (904) 725-6463
Fax: (904) 724-5006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME0048902 Florida
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME48902 Florida

Profile Details

NPI number 1962471169
LBN Legal business name Shah, Atul Mukutbhai
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 17th, 2006
Last updated Feb 24th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962471169 NPPES
Florida MEDICAID 043765400

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