Provider Demographics
NPI:1053345629
Name:SHAH, CHIRAG M (MD)
Entity type:Individual
Prefix:
First Name:CHIRAG
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:40 BEY LEA RD
Mailing Address - Street 2:SUITE B 102
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-244-3380
Mailing Address - Fax:732-244-9013
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:SUITE B 102
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-244-3380
Practice Address - Fax:732-244-9013
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2018-03-29
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Provider Licenses
StateLicense IDTaxonomies
NY221447207R00000X
NJ25MA06728200207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02634499Medicaid
NY02634499Medicaid