Healthcare Provider Details

I. General information

NPI: 1427460211
Provider Name (Legal Business Name): HIRAL SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2014
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 WILLOW OAKS CORPORATE DR STE 400
FAIRFAX VA
22031-4513
US

IV. Provider business mailing address

8260 WILLOW OAKS CORPORATE DR STE 400
FAIRFAX VA
22031-4513
US

V. Phone/Fax

Practice location:
  • Phone: 703-573-0504
  • Fax:
Mailing address:
  • Phone: 703-573-0504
  • Fax: 703-573-4856

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number101286398
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLP03029
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301112559
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: