Shah, Hardik C

Shah, Hardik C is an individual health care provider with primary practice located at 820 Prudential Dr Ste 304 Credentialing Department, Jacksonville FL 32207-8205. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Shah, Hardik C can be contacted via phone (904) 346-3649.

Contact Information

Primary practice address
820 Prudential Dr Ste 304 Credentialing Department Jacksonville FL 32207-8205
Phone: (904) 346-3649
Fax: (904) 348-5627
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME97803 Florida
Allopathic & Osteopathic Physicians / Geriatric Medicine 207RG0300X 01058275 Indiana

Profile Details

NPI number 1750377784
LBN Legal business name Shah, Hardik C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Jan 3rd, 2019 - about 6 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 1750377784 NPPES
Florida MEDICAID 2778041-00
Florida Other P00469548

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