Provider Demographics
NPI:1902955255
Name:SHAH, LUBDHA M (MD)
Entity Type:Individual
Prefix:
First Name:LUBDHA
Middle Name:M
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:30 N 1900 E RM 1A71
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84132-0002
Mailing Address - Country:US
Mailing Address - Phone:801-581-8699
Mailing Address - Fax:801-585-7330
Practice Address - Street 1:30 N 1900 E RM 1A71
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84132-0002
Practice Address - Country:US
Practice Address - Phone:801-581-8699
Practice Address - Fax:801-585-7330
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2021-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT6844992-12052085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology