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General NPI Number Information
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NPI Number | 1841451879
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Entity Type | Individual
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Provider Name | ANIL SHUKLA MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 459 LOCUST AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902
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Country | US
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Telephone | 434-654-7150
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Fax | 434-982-7147
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Provider Business Mailing Address
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Address Line | 459 LOCUST AVE
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22902
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Country | US
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Telephone | 434-654-7150
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Fax | 434-982-7147
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101247500
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License Number State | VA
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