Individual provider · Type 1 NPI
Pratish Ajay Shah, MD
Neuroradiology Physician · Springfield, IL
NPI number
1104142512
Active
Practice location
1025 S 6th St
Springfield, IL 62703-2499
Mailing address
PO Box 19248
Springfield, IL 62794-9248
Other practice locations
- 3186 Village Dr Ste 201, Fayetteville, NC 28304-3979 · (910) 486-5700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Neuroradiology Physician Primary | 2085N0700X | 036137694 (IL) |
| Neuroradiology Physician | 2085N0700X | 2020-02657 (NC) |
| Diagnostic Radiology Physician | 2085R0202X | 2020-02657 (NC) |
Neuroradiology Physician: A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children.
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About NPI 1104142512
Pratish Ajay Shah, MD's National Provider Identifier is 1104142512, issued on Apr 9, 2010. The primary taxonomy on file is Neuroradiology Physician (2085N0700X), and the practice location is in Springfield, IL. The record was last updated on Apr 22, 2026.