Provider Demographics
NPI:1194017657
Name:SHAH, GOONJAN SUNIL (MD)
Entity Type:Individual
Prefix:
First Name:GOONJAN
Middle Name:SUNIL
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:DEPARTMENT OF ANESTHESIOLOGY
Mailing Address - Street 2:CB 7010, N2201 UNC HOSPITALS
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7010
Mailing Address - Country:US
Mailing Address - Phone:919-966-5136
Mailing Address - Fax:919-966-4873
Practice Address - Street 1:7230 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1907
Practice Address - Country:US
Practice Address - Phone:818-348-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-03
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172907390200000X
CAA136333208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program