MEDICARE: CHATHAM FAMILY MEDICAL CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1225237456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHATHAM FAMILY MEDICAL CENTER, INC

Provider Business Mailing Address
First Line	:	13908 US HIGHWAY 29
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-3669
Country	:	US
Telephone Number	:	434-432-0216
Fax Number	:	434-432-3425

Provider Business Practice Location Address
First Line	:	13908 US HIGHWAY 29
Second Line	:
City	:	CHATHAM
State	:	VA
Zip	:	24531-3669
Country	:	US
Telephone Number	:	434-432-0216
Fax Number	:	434-432-3425

Authorized Official
Title or Position	:	PRESIDENT/PHYSICIAN
Name	:	MINESH R SHAH
Credential	:	M.D.
Telephone Number	:	434-432-0216

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	11/22/2022

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