Healthcare Provider Details

I. General information

NPI: 1801008271
Provider Name (Legal Business Name): NADIA SHAH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2007
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8001 FORBES PL SUITE 103
SPRINGFIELD VA
22151-2208
US

IV. Provider business mailing address

8001 FORBES PL SUITE 103
SPRINGFIELD VA
22151-2208
US

V. Phone/Fax

Practice location:
  • Phone: 703-824-3200
  • Fax: 703-321-3300
Mailing address:
  • Phone: 703-824-3200
  • Fax: 703-321-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number27695
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number9590A
License Number StateWY
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101253198
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number53388
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: