MEDICARE: ASIF SHAH DPM

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	213ES0131X	Foot Surgery Podiatrist	0103300899	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00326083	OTHER	VA	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	172530	OTHER	VA	ANTHEM
2	2610193	OTHER	VA	CIGNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3367610	OTHER	VA	AETNA HMO
5	146328	OTHER	VA	ANTHEM
6	3119449	OTHER	VA	MAMSI
7	32-0038270	OTHER	VA	UNITED HEALTH CARE
9	7547482	OTHER	VA	AETNA PPO
10	32-0038270-001	OTHER	VA	TRICARE

General Provider Information

NPI Number	:	1669418786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASIF SHAH DPM

Provider Business Mailing Address
First Line	:	3936 SPRINGFIELD RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060
Country	:	US
Telephone Number	:	804-934-9340
Fax Number	:	804-934-9381

Provider Business Practice Location Address
First Line	:	3936 SPRINGFIELD RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060
Country	:	US
Telephone Number	:	804-934-9340
Fax Number	:	804-934-9381

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	01/02/2008

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