Shah, Samir K
Shah, Samir K is an individual health care provider with primary practice located at 4600 Memorial Dr Ste 300 , Belleville IL 62226-5363. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Geriatric Medicine, Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease. Allopathic & Osteopathic Physicians / Cardiovascular Disease is his primary health care specialty. Shah, Samir K can be contacted via phone (618) 233-3066.Contact Information
Primary practice address
4600 Memorial Dr Ste 300
Belleville IL 62226-5363
Phone: (618) 233-3066
Fax: (314) 996-7658
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 036-063403 | Illinois |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207RA0000X | 036-063403 | Illinois |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036-063403 | Illinois |
Profile Details
| NPI number | 1427072768 |
|---|---|
| LBN Legal business name | Shah, Samir K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Apr 30th, 2024 - about 7 months 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427072768 | NPPES |
| Illinois | Other | 01636052 | BCBS |
| Illinois | MEDICAID | 036063403 | BCBS |
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