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General NPI Number Information
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NPI Number | 1760010094
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Entity Type | Individual
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Provider Name | PREEYA TUSHAR SHAH MD
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Gender | Female
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 1301 CASTLEPOINTE DR
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City | FUQUAY VARINA
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State | NC
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Zip | 27526-4351
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Country | US
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Telephone | 984-849-4328
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Fax | 919-763-1380
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Provider Business Mailing Address
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Address Line | 2238 NELSON HWY STE 100
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City | CHAPEL HILL
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State | NC
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Zip | 27517-8914
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Country | US
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Telephone | 919-401-1994
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Fax | 919-401-1924
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 2024-02348
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License Number State | NC
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