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General NPI Number Information
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NPI Number | 1073132957
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Entity Type | Individual
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Provider Name | PRAHAR SHAH MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2020
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Last Update Date | 11/18/2025
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Provider Practice Location Address
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Address Line | 4420 LAKE BOONE TRL STE 100
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone | 984-215-6950
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Fax | 984-215-6951
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Provider Business Mailing Address
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Address Line | 4420 LAKE BOONE TRL STE 100
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City | RALEIGH
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State | NC
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Zip | 27607-7505
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Country | US
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Telephone |
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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 | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 2025-03006
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 2025-03006
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License Number State | NC
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