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General NPI Number Information
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NPI Number | 1407908445
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Entity Type | Organization
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Legal Business Name | MAHENDRA D.SHAH,M.D.& ASSOCIATES,P.C.
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4207 WHITFORD CT # 1703
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4138
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Country | US
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Telephone | 180-476-1016
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Fax | 180-476-1016
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Provider Business Mailing Address
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Address Line | 4207 WHITFORD CT # 1703
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City | GLEN ALLEN
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State | VA
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Zip | 23060-4138
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Country | US
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Telephone | 180-476-1016
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Fax | 180-476-1016
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MAHENDRA DEVSHIBHAI SHAH
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Credential | M.D.
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Telephone | 180-476-1016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 0101045906
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License Number State | VA
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