Provider Demographics
NPI:1750511416
Name:SHAH, HASSAN MURTAZA (MD)
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:MURTAZA
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:725 VOLVO PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-1621
Mailing Address - Country:US
Mailing Address - Phone:757-252-4130
Mailing Address - Fax:757-410-9705
Practice Address - Street 1:725 VOLVO PKWY STE 210
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-1621
Practice Address - Country:US
Practice Address - Phone:757-252-4130
Practice Address - Fax:757-410-9705
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-15
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101258149207X00000X
PAMT195974207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery