Shah, Basil

Shah, Basil is an individual health care provider with primary practice located at 1340 Broad Ave Suite 450, Gulfport MS 39501-2404. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Shah, Basil can be contacted via phone (228) 867-5006.

Contact Information

Primary practice address
1340 Broad Ave Suite 450 Gulfport MS 39501-2404
Phone: (228) 867-5006
Fax: (228) 867-5079
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4301077845 Michigan
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 22774 Mississippi
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 22774 Mississippi

Profile Details

NPI number 1679684872
LBN Legal business name Shah, Basil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 31st, 2014 - about 11 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 1679684872 NPPES
Louisiana Other 107229 AL MEDICAID
Louisiana Other 00188398 AL MEDICAID

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