MEDICARE: DR. MINESH SHAH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101236035	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00454688	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	338474	OTHER	ANTHEM BLUE CROSS
5	1673053	OTHER	CIGNA
6	732430	OTHER	SOUTHERN HEALTH

General Provider Information

NPI Number	:	1518960673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINESH SHAH M.D.

Provider Business Mailing Address
First Line	:	13908 US HIGHWAY 29
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-3669
Country	:	US
Telephone Number	:	434-432-0216
Fax Number	:	434-432-3425

Provider Business Practice Location Address
First Line	:	13908 US HIGHWAY 29
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-3669
Country	:	US
Telephone Number	:	434-432-0216
Fax Number	:	434-432-3425

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	11/22/2022

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Directions to “ DR. MINESH SHAH M.D.” Practice Location

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