Provider Demographics
NPI:1548465792
Name:SHAH, KESHA DESAI (MD)
Entity type:Individual
Prefix:DR
First Name:KESHA
Middle Name:DESAI
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5220 GREENS DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-4612
Mailing Address - Country:US
Mailing Address - Phone:919-256-3576
Mailing Address - Fax:
Practice Address - Street 1:3200 BLUE RIDGE RD STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8087
Practice Address - Country:US
Practice Address - Phone:919-781-1437
Practice Address - Fax:919-787-4870
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC29983207R00000X, 2085R0202X
NC2012-006902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine