Provider Demographics
NPI:1437458981
Name:SHAMS, ROUZBEH (MD)
Entity Type:Individual
Prefix:
First Name:ROUZBEH
Middle Name:
Last Name:SHAMS
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 1:3241 WESTERN BRANCH BLVD
Mailing Address - Street 2:BAYVIEW PHYSICIAN GROUP
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5260
Mailing Address - Country:US
Mailing Address - Phone:757-686-3500
Mailing Address - Fax:
Practice Address - Street 1:3241 WESTERN BRANCH BLVD
Practice Address - Street 2:BAYVIEW PHYSICIAN GROUP
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-5260
Practice Address - Country:US
Practice Address - Phone:757-686-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255273208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10130501OtherOPTIMA HEALTH
VA1437458981OtherCOVENTRY NETWORK
NC1437458981Medicaid
VAPAROtherCORVEL
VA1437458981Medicaid
VAPAROtherVIRGINIA HEALTH NETWORK
VA1437458981OtherVIRGINIA PREMIER HEALTH PLAN
VAPAROtherAETNA
VA-028OtherTRICARE/CHAMPUS
VAPAROtherUSA MANAGED CARE
VA1437458981OtherUNITED HEALTHCARE
VA1437458981OtherCIGNA
VA520626OtherANTHEM BC/BS
VAPAROtherMULTIPLAN
VAPAROtherMULTIPLAN
VA10130501OtherOPTIMA HEALTH