Provider Demographics
NPI:1033470091
Name:VIRANI, SHAHAB S (MD)
Entity Type:Individual
Prefix:
First Name:SHAHAB
Middle Name:S
Last Name:VIRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 THORNTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4654
Mailing Address - Country:US
Mailing Address - Phone:540-371-6810
Mailing Address - Fax:540-371-9154
Practice Address - Street 1:1300 THORNTON ST STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4654
Practice Address - Country:US
Practice Address - Phone:540-371-6810
Practice Address - Fax:540-371-9154
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP02643207R00000X
VA0101263309207R00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine