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Dr. Yogendra Ambalal Shah, MD,SC
Specialist in Granite City, Illinois
NPI 1376667253

Yogendra Ambalal Shah is a Specialist based in Granite City, IL. Yogendra Ambalal Shah practices in Granite City, IL and has the professional credentials of MD,SC. The NPI Number for Yogendra Ambalal Shah is 1376667253 and holds a License No. 036048989 (Illinois).

The current practice location address for Yogendra Ambalal Shah is 3165 Myrtle Ave, Granite City, IL and can be reached out via phone at 618-451-7717 and via fax at 618-451-7780. You can also correspond with Yogendra Ambalal Shah through the mailing address at 3165 MYRTLE AVE, GRANITE CITY, IL - 62040-5012 (mailing address contact number: 618-451-7717).

Location: 3165 Myrtle Ave, Granite City, IL, 62040-5012
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1376667253
Provider Name
Yogendra Ambalal Shah
Credential
MD,SC
Provider Entity Type
Individual
Gender
Male
Address
3165 Myrtle Ave, Granite City, IL, 62040-5012
Phone Number
618-451-7717
Fax Number
618-451-7780
Provider Enumeration Date
03/18/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
036048989 05 IL
institution
Provider Business Practice Location Address Details
Address
3165 Myrtle Ave
City
Granite City
State
Illinois
Zip
62040-5012
Phone Number
618-451-7717
Fax Number
618-451-7780
person
Provider Business Mailing Address Details
Address
3165 Myrtle Ave
City
Granite City
State
Illinois
Zip
62040-5012
Phone Number
618-451-7717
Fax Number
618-451-7780
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036048989 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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