Provider Demographics
NPI:1740209147
Name:SHAH, RUPA N (MD)
Entity Type:Individual
Prefix:DR
First Name:RUPA
Middle Name:N
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:6354 WALKER LN STE 400
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3252
Practice Address - Country:US
Practice Address - Phone:571-472-7320
Practice Address - Fax:571-472-7321
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA 95548207RG0100X
VA0101246544207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology