| Darshan J Shah Md Llc | |
|
139 Hazard Ave Bldg 4 Enfield CT 06082-4583 | |
| (860) 763-0208 | |
| Not Available |
| Full Name | Darshan J Shah Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 139 Hazard Ave Bldg 4, Enfield, Connecticut |
| Authorized Official Name and Position | Darshan J Shah (MEMBER) |
| Authorized Official Contact | 8607630208 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Darshan J Shah Md Llc 47 E Main St Stafford Springs CT 06076-1227 Ph: (860) 684-5871 | Darshan J Shah Md Llc 139 Hazard Ave Bldg 4 Enfield CT 06082-4583 Ph: (860) 763-0208 |
| NPI Number | 1366776775 |
|---|---|
| Provider Enumeration Date | 10/01/2009 |
| Last Update Date | 10/01/2009 |
| Medicare PECOS PAC ID | 0547300857 |
|---|---|
| Medicare Enrollment ID | O20091217000470 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366776775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 038479 (Connecticut) | Primary |
| Provider Name | Darshan J Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558355750 PECOS PAC ID: 6305986613 Enrollment ID: I20091217000431 |
| Provider Name | Nadine S Caron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487027678 PECOS PAC ID: 4082919097 Enrollment ID: I20160229000853 |
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