MEDICARE: DR. PURVI K SHAH M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	27854	AL
2	207RH0003X	Hematology & Oncology Physician	27854	AL
3	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician	0101235368	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00603050	OTHER	AL	RR MEDICARE
4	CA0084	OTHER	AL	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51541336	OTHER	AL	BCBS OF ALABAMA
3	51542615	OTHER	AL	BCBS OF ALABAMA
5	4909355	OTHER	VA	CIGNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	510-50070	OTHER	AL	BCBS OF ALABAMA
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
13	51542612	OTHER	AL	BCBS OF ALABAMA

NPI Number	:	1275580722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PURVI K SHAH M.D.

Provider Business Mailing Address
First Line	:	7202 GLEN FOREST DR
Second Line	:	STE 200
City	:	RICHMOND
State	:	VA
Zip	:	23226-3780
Country	:	US
Telephone Number	:	804-673-2024
Fax Number	:	804-673-1796

Provider Business Practice Location Address
First Line	:	8007 DISCOVERY DR STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-8605
Country	:	US
Telephone Number	:	804-287-3000
Fax Number	:	804-673-2731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/17/2022