Provider Demographics
NPI:1730409095
Name:SHAH, MITAL (MD)
Entity type:Individual
Prefix:
First Name:MITAL
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4201 BEE CAVES RD STE C100
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6493
Mailing Address - Country:US
Mailing Address - Phone:512-327-1155
Mailing Address - Fax:
Practice Address - Street 1:4201 BEE CAVES RD STE C100
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6493
Practice Address - Country:US
Practice Address - Phone:512-327-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR8664208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC4181397OtherCOVENTRY NATIONAL - COVENTRY PPO
NC1730409095OtherHUMANA
NC4974486OtherAETNA
NC1420402OtherWELLPATH
NC1730409095OtherHEALTHNET FEDERAL SERVICES
NC1730409095OtherDOCTORS DIRECT
NC1730409095OtherHEALTHSMART
NC1730409095Medicaid
NC248103OtherMEDCOST, LLC
NC1420402OtherCOVENTRY OF THE CAROLINAS
NC13318114OtherPHCS-MULTIPLAN
NC5825698OtherCIGNA
NCFH1101550OtherFIRST CAROLINA CARE
NC184R9OtherBCBS OF NC
NC3667912OtherUNITED HEALTHCARE