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General NPI Number Information
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NPI Number | 1023639036
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Entity Type | Individual
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Provider Name | ANUJ A SHAH DO
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Gender | Male
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 400 COURT ST STE 100
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City | CHARLESTON
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State | WV
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Zip | 25301-1652
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Country | US
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Telephone | 304-347-6120
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Fax |
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Provider Business Mailing Address
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Address Line | 400 COURT ST STE 100
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City | CHARLESTON
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State | WV
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Zip | 25301-1652
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Country | US
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Telephone | 304-347-6120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 328801-1
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License Number State | NY
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