Provider Demographics
NPI:1831578319
Name:SHAH, MONIL R (MD)
Entity type:Individual
Prefix:DR
First Name:MONIL
Middle Name:R
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:HSC LEVEL 4, ROOM 176
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794-8430
Mailing Address - Country:US
Mailing Address - Phone:631-444-2084
Mailing Address - Fax:
Practice Address - Street 1:130 HOSPITAL RD STE 300
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4057
Practice Address - Country:US
Practice Address - Phone:410-535-4333
Practice Address - Fax:410-535-3260
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2022-06-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD464011207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine