Provider Demographics
NPI:1447383450
Name:SHAH, ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COLISEUM BLVD
Mailing Address - Street 2:P O BOX 3223
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2707
Mailing Address - Country:US
Mailing Address - Phone:334-279-7830
Mailing Address - Fax:334-279-3714
Practice Address - Street 1:101 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-2707
Practice Address - Country:US
Practice Address - Phone:334-279-7830
Practice Address - Fax:337-279-3714
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD125092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00005150208Medicare ID - Type Unspecified