Provider Demographics
NPI:1821371527
Name:SHAH, PARINAZ R (MD)
Entity type:Individual
Prefix:DR
First Name:PARINAZ
Middle Name:R
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:109 C FLEETWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-2019
Mailing Address - Country:US
Mailing Address - Phone:864-850-0700
Mailing Address - Fax:864-850-0705
Practice Address - Street 1:109 C FLEETWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-2019
Practice Address - Country:US
Practice Address - Phone:864-850-0700
Practice Address - Fax:864-850-0705
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SCPA1662363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA1662OtherSC MEDICAL LICENSE