1467853929 NPI number — DR. SALIL TAROON SHAH M.D.

Table of content: DR. SALIL TAROON SHAH M.D. (NPI 1467853929)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467853929 NPI number — DR. SALIL TAROON SHAH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAH
Provider First Name:
SALIL
Provider Middle Name:
TAROON
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467853929
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 MICCOSUKEE RD
Provider Second Line Business Mailing Address:
HOSPITALIST GROUP
Provider Business Mailing Address City Name:
TALLAHASSEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32308-5054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-431-4556
Provider Business Mailing Address Fax Number:
850-431-6315

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 MICCOSUKEE ROAD
Provider Second Line Business Practice Location Address:
TMH/FSU INTERNAL MEDICINE RESIDENCY PROGRAM
Provider Business Practice Location Address City Name:
TALLAHASSEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32308-5607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-431-7900
Provider Business Practice Location Address Fax Number:
850-431-8251
Provider Enumeration Date:
09/15/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  68632 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 20668 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208M00000X , with the licence number: 01079170A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)