Basic Information
Provider Information
NPI: 1639431919
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHAH
FirstName: HEMANG
MiddleName: JAGDISH
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
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Mailing Information
Address1: UK DIVISION OF HOSPITAL MEDICINE
Address2: 800 ROSE ST, MN604
City: LEXINGTON
State: KY
PostalCode: 405360298
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Practice Location
Address1: UK DIVISION OF HOSPITAL MEDICINE
Address2: 800 ROSE ST, MN604
City: LEXINGTON
State: KY
PostalCode: 405360298
CountryCode: US
TelephoneNumber: 8593236047
FaxNumber: 8592573873
Other Information
ProviderEnumerationDate: 06/12/2012
LastUpdateDate: 09/14/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X03853KYY Allopathic & Osteopathic PhysiciansHospitalist 
207R00000X03853KYN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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