Provider Demographics
NPI:1083607741
Name:SHAH, ALAP PRAVIN (DPM)
Entity Type:Individual
Prefix:
First Name:ALAP
Middle Name:PRAVIN
Last Name:SHAH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-8927
Mailing Address - Country:US
Mailing Address - Phone:706-327-8819
Mailing Address - Fax:706-327-3147
Practice Address - Street 1:2000 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-327-8819
Practice Address - Fax:706-327-3147
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD 000971213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00970021AMedicaid
GA00970021AMedicaid
GA48SCCKZMedicare ID - Type UnspecifiedMEDICARE