Provider Demographics
NPI:1871741751
Name:SHAH, JIGNESH (MD)
Entity type:Individual
Prefix:
First Name:JIGNESH
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2310 HOLMES ST
Mailing Address - Street 2:STE 800
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2602
Mailing Address - Country:US
Mailing Address - Phone:816-218-2523
Mailing Address - Fax:816-285-6923
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:DEPT OF MEDICINE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2640
Practice Address - Country:US
Practice Address - Phone:816-404-1000
Practice Address - Fax:816-404-5014
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2017-10-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036130005207RN0300X
MO2015012835207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL214881Medicare Oscar/Certification