MEDICARE: DR. MOIN SHAH SAIYED M.D.

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	207L00000X	Anesthesiology Physician	0101236371	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336146885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOIN SHAH SAIYED M.D.

Provider Business Mailing Address
First Line	:	PO BOX 17978
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23226-7978
Country	:	US
Telephone Number	:	804-289-4937
Fax Number	:	804-565-6600

Provider Business Practice Location Address
First Line	:	7700 E PARHAM RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23294-4301
Country	:	US
Telephone Number	:	804-289-4937
Fax Number	:	804-565-6600

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	02/19/2014

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