Shah, Mrudula J

Shah, Mrudula J is an individual health care provider with primary practice located at 1101 St Christopher Dr Same Day Surgery Ctr. Ste 340, Ashland KY 41101. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Shah, Mrudula J can be contacted via phone (606) 836-8188.

Contact Information

Primary practice address
1101 St Christopher Dr Same Day Surgery Ctr. Ste 340 Ashland KY 41101
Phone: (606) 836-8188
Fax: (606) 836-8177
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 19399 Kentucky

Profile Details

NPI number 1427144823
LBN Legal business name Shah, Mrudula J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 19 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 1427144823 NPPES
Kentucky Other 19399 LICENSE NUMBER
Kentucky MEDICAID 64193998 LICENSE NUMBER

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