Provider Demographics
NPI:1083709182
Name:SHAH, MAHIR I (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHIR
Middle Name:I
Last Name:SHAH
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 1:1020 EMORY LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0092
Mailing Address - Country:US
Mailing Address - Phone:803-372-8585
Mailing Address - Fax:800-598-6601
Practice Address - Street 1:951 MARKET ST STE 205
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-6529
Practice Address - Country:US
Practice Address - Phone:803-372-8585
Practice Address - Fax:800-598-6601
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC210012084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC327877Medicaid
SC3344Medicare UPIN
SC327877Medicaid