Individual
BANSI P SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3318 HEALY DR, WINSTON SALEM, NC 27103-1404
(336) 768-3530
(336) 768-1329
Mailing address
3318 HEALY DR, WINSTON SALEM, NC 27103-1404
(336) 768-3530
(336) 768-1329
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17432
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1022
PARTNERS
NC
01
—
147909
TRIGON
—
01
—
4098739
AETNA
—
01
—
73-0902-3
VA MEDICAID
—
01
—
75396
BCBSNC
NC
05
—
8975396
—
NC
Enumeration date
05/26/2006
Last updated
10/12/2010
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