Provider Demographics
NPI:1528004447
Name:SHIH, GRACE L (MD)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:L
Last Name:SHIH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:190 CAMPUS BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2872
Mailing Address - Country:US
Mailing Address - Phone:540-667-1244
Mailing Address - Fax:540-667-3086
Practice Address - Street 1:190 CAMPUS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2872
Practice Address - Country:US
Practice Address - Phone:540-667-1244
Practice Address - Fax:540-667-3086
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101239367207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1528004447Medicaid