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General NPI Number Information
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NPI Number | 1669418786
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Entity Type | Individual
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Provider Name | ASIF SHAH DPM
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 01/02/2008
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Provider Practice Location Address
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Address Line | 3936 SPRINGFIELD RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060
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Country | US
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Telephone | 804-934-9340
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Fax | 804-934-9381
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Provider Business Mailing Address
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Address Line | 3936 SPRINGFIELD RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060
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Country | US
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Telephone | 804-934-9340
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Fax | 804-934-9381
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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 | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 0103300899
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License Number State | VA
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