Provider Demographics
NPI:1710948146
Name:ARVIND B SHAH MD INC
Entity Type:Organization
Organization Name:ARVIND B SHAH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-766-4350
Mailing Address - Street 1:401 DIVISION ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1455
Mailing Address - Country:US
Mailing Address - Phone:304-766-4350
Mailing Address - Fax:304-766-4355
Practice Address - Street 1:401 DIVISION ST
Practice Address - Street 2:STE 100
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1455
Practice Address - Country:US
Practice Address - Phone:304-766-4350
Practice Address - Fax:304-766-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVCK4653OtherRAIL ROAD MEDICARE
WV0010637000Medicaid
WVCK4653OtherRAIL ROAD MEDICARE
WV9293411Medicare PIN