Provider Demographics
NPI:1629164215
Name:SHAH, MELIHA HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELIHA
Middle Name:HASSAN
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850-A TOWN CENTER PARKWAY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190
Mailing Address - Country:US
Mailing Address - Phone:703-437-5532
Mailing Address - Fax:703-437-7022
Practice Address - Street 1:1850 TOWN CENTER PARKWAY
Practice Address - Street 2:SUITE 209
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190
Practice Address - Country:US
Practice Address - Phone:703-437-5532
Practice Address - Fax:703-437-5532
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101221462207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H13692Medicare UPIN
DCH13692Medicare UPIN
DCG01961I02Medicare ID - Type UnspecifiedN.VA/DC METRO