Individual
RUDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 272-1050
Mailing address
1206 SOUTHPOINT TRL, DURHAM, NC 27713-6755
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5017865
NC
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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