Healthcare Provider Details

I. General information

NPI: 1154061802
Provider Name (Legal Business Name): RUMIN M. SHAH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 HUFFMAN MILL RD
BURLINGTON NC
27215-8700
US

IV. Provider business mailing address

1500 HIGHLANDS DR
LITITZ PA
17543-7694
US

V. Phone/Fax

Practice location:
  • Phone: 336-538-7000
  • Fax:
Mailing address:
  • Phone: 717-625-5668
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2026-02231
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: